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Gastrointestinal
Diagnosis
Liver
Treatment Related
Radiation-Induced Liver Disease
Radiation-Induced Liver Disease
Atif Zaheer, MD; 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

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    Selected References

                                    1. De La Pinta Alonso C: Radiation-induced liver disease in the era of SBRT: a review. Expert Rev Gastroenterol Hepatol. 14(12):1195-201, 2020
                                    2. Koay EJ et al: Radiation-induced liver disease and modern radiotherapy. Semin Radiat Oncol. 28(4):321-31, 2018
                                    3. Takamatsu S et al: Pathology and images of radiation-induced hepatitis: a review article. Jpn J Radiol. 36(4):241-56, 2018
                                    4. Munoz-Schuffenegger P et al: Radiation-induced liver toxicity. Semin Radiat Oncol. 27(4):350-7, 2017
                                    5. 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
                                    6. 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
                                    7. Tao C et al: Improved radiotherapy for primary and secondary liver cancer: stereotactic body radiation therapy. Anticancer Res. 32(2):649-55, 2012
                                    8. Guha C et al: Hepatic radiation toxicity: avoidance and amelioration. Semin Radiat Oncol. 21(4):256-63, 2011
                                    9. Nalesnik MA et al: Hepatobiliary effects of 90yttrium microsphere therapy for unresectable hepatocellular carcinoma. Hum Pathol. 40(1):125-34, 2009
                                    10. 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
                                    11. 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
                                    12. 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
                                    13. Willemart S et al: Acute radiation-induced hepatic injury: evaluation by triphasic contrast enhanced helical CT. Br J Radiol. 73(869):544-6, 2000
                                    14. 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

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      Selected References

                                                                      1. De La Pinta Alonso C: Radiation-induced liver disease in the era of SBRT: a review. Expert Rev Gastroenterol Hepatol. 14(12):1195-201, 2020
                                                                      2. Koay EJ et al: Radiation-induced liver disease and modern radiotherapy. Semin Radiat Oncol. 28(4):321-31, 2018
                                                                      3. Takamatsu S et al: Pathology and images of radiation-induced hepatitis: a review article. Jpn J Radiol. 36(4):241-56, 2018
                                                                      4. Munoz-Schuffenegger P et al: Radiation-induced liver toxicity. Semin Radiat Oncol. 27(4):350-7, 2017
                                                                      5. 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
                                                                      6. 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
                                                                      7. Tao C et al: Improved radiotherapy for primary and secondary liver cancer: stereotactic body radiation therapy. Anticancer Res. 32(2):649-55, 2012
                                                                      8. Guha C et al: Hepatic radiation toxicity: avoidance and amelioration. Semin Radiat Oncol. 21(4):256-63, 2011
                                                                      9. Nalesnik MA et al: Hepatobiliary effects of 90yttrium microsphere therapy for unresectable hepatocellular carcinoma. Hum Pathol. 40(1):125-34, 2009
                                                                      10. 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
                                                                      11. 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
                                                                      12. 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
                                                                      13. Willemart S et al: Acute radiation-induced hepatic injury: evaluation by triphasic contrast enhanced helical CT. Br J Radiol. 73(869):544-6, 2000
                                                                      14. Unger EC et al: CT and MR imaging of radiation hepatitis. J Comput Assist Tomogr. 11(2):264-8, 1987