Diagnostic value of methods of visualizing toxic liver damage after systemic polychemotherapy (systematic literature review and analysis of our experience)
Lavryk G.V., Golovko T.S., Sivak L.A., Shevchuk L., Ashykhmin A.V.
Summary. In this paper we analyzed multiple papers in regard to chemotherapy – induced toxic liver injury and the use of radiologic methods to assess treatment response among patients with malignant tumors of different locations and biology. In the current study we summarized and analyzed results of radiologic methods (ultrasound, MRI, CT) to assess radiologic appearance of chemotherapy-induced liver injury in setting of multiple liver metastasis as well as toxic liver appearance without liver metastasis. We delineated major toxic effects on liver parenchyma during comparison of different diagnostic tools. Our results support that chemotherapy directly acts on malignant liver tumors (in metastatic disease) as well as impacts normal liver parenchyma. Chemotherapy causes liver sinus damage, steatosis and steatohepatitis, what may mask metastasis. Diagnostic monitoring during chemotherapy allows to assess treatment effectiveness and visualize heterogenous changes of liver parenchyma. Use of radiologic methods to visualize pathologic changes in liver in timely fashion plays a role for further use of more accurate methods, allows to futher minimize toxic effcts and change treatment to avoid undesirable complications.
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