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Radiation-Induced Liver Disease
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Radiation-induced liver disease (RILD)
            • Definitions

              • Syndrome characterized by development of anicteric ascites ~ 2 weeks to 4 months after hepatic irradiation
              • Form of venoocclusive disease due to fibrous obliteration of terminal hepatic venules → postsinusoidal obstruction

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Jung J et al: Radiation-induced liver disease after stereotactic body radiotherapy for small hepatocellular carcinoma: clinical and dose-volumetric parameters. Radiat Oncol. 8:249, 2013
                                  2. Ng SC et al: Patient dosimetry for 90Y selective internal radiation treatment based on 90Y PET imaging. J Appl Clin Med Phys. 14(5):212-21, 2013
                                  3. Tao C et al: Improved radiotherapy for primary and secondary liver cancer: stereotactic body radiation therapy. Anticancer Res. 32(2):649-55, 2012
                                  4. Guha C et al: Hepatic radiation toxicity: avoidance and amelioration. Semin Radiat Oncol. 21(4):256-63, 2011
                                  5. Nalesnik MA et al: Hepatobiliary effects of 90yttrium microsphere therapy for unresectable hepatocellular carcinoma. Hum Pathol. 40(1):125-34, 2009
                                  6. Neff R et al: The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors. Cancer Invest. 26(2):173-7, 2008
                                  7. Szyszko T et al: Management and prevention of adverse effects related to treatment of liver tumours with 90Y microspheres. Nucl Med Commun. 28(1):21-4, 2007
                                  8. Mori H et al: Radiation-induced liver injury showing low intensity on T2-weighted images noted in Budd-Chiari syndrome. Radiat Med. 20(2):69-76, 2002
                                  9. Willemart S et al: Acute radiation-induced hepatic injury: evaluation by triphasic contrast enhanced helical CT. Br J Radiol. 73(869):544-6, 2000
                                  10. Unger EC et al: CT and MR imaging of radiation hepatitis. J Comput Assist Tomogr. 11(2):264-8, 1987
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Radiation-induced liver disease (RILD)
                                            • Definitions

                                              • Syndrome characterized by development of anicteric ascites ~ 2 weeks to 4 months after hepatic irradiation
                                              • Form of venoocclusive disease due to fibrous obliteration of terminal hepatic venules → postsinusoidal obstruction

                                            IMAGING

                                            • General Features

                                              • CT Findings

                                                • MR Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Microscopic Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Jung J et al: Radiation-induced liver disease after stereotactic body radiotherapy for small hepatocellular carcinoma: clinical and dose-volumetric parameters. Radiat Oncol. 8:249, 2013
                                                                  2. Ng SC et al: Patient dosimetry for 90Y selective internal radiation treatment based on 90Y PET imaging. J Appl Clin Med Phys. 14(5):212-21, 2013
                                                                  3. Tao C et al: Improved radiotherapy for primary and secondary liver cancer: stereotactic body radiation therapy. Anticancer Res. 32(2):649-55, 2012
                                                                  4. Guha C et al: Hepatic radiation toxicity: avoidance and amelioration. Semin Radiat Oncol. 21(4):256-63, 2011
                                                                  5. Nalesnik MA et al: Hepatobiliary effects of 90yttrium microsphere therapy for unresectable hepatocellular carcinoma. Hum Pathol. 40(1):125-34, 2009
                                                                  6. Neff R et al: The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors. Cancer Invest. 26(2):173-7, 2008
                                                                  7. Szyszko T et al: Management and prevention of adverse effects related to treatment of liver tumours with 90Y microspheres. Nucl Med Commun. 28(1):21-4, 2007
                                                                  8. Mori H et al: Radiation-induced liver injury showing low intensity on T2-weighted images noted in Budd-Chiari syndrome. Radiat Med. 20(2):69-76, 2002
                                                                  9. Willemart S et al: Acute radiation-induced hepatic injury: evaluation by triphasic contrast enhanced helical CT. Br J Radiol. 73(869):544-6, 2000
                                                                  10. Unger EC et al: CT and MR imaging of radiation hepatitis. J Comput Assist Tomogr. 11(2):264-8, 1987