Joy, D.; Thava, V.R. Of 269 patients, 76 (28.3%) had steatosis at baseline. All ultrasonographic examinations were performed in the ultrasound unit by experienced physicians. Wolfgang Dhnert. Vigano, L.; De Rosa, G.; Toso, C.; Andres, A.; Ferrero, A.; Roth, A.; Sperti, E.; Majno, P.; Rubbia-Brandt, L. Reversibility of chemotherapy-related liver injury. ; McKillop, J.H. Sohn J, Siegelman E, Osiason A. Without continually carrying out new studies at regular intervals, no comparative statements concerning possible changes in the prevalence of benign focal liver lesions over time are possible. The present case revealed a wedge-shaped area with an almost linear boundary and did not show a mass effect in the non-enhanced CT and MR sequence, including chemical shift images. Only a few studies have determined the prevalence of FNH, hepatic adenoma and focal fatty sparing. We present the radiological features of this case and discuss how to arrive at a correct diagnosis. 2). The examinations were evaluated for the presence of a focal area of increased attenuation in the liver in locations where focal fatty sparing typically occurs: adjacent to the gallbladder fossa and in the medial segment of the left lobe near the porta hepatis. Focal fat sparing and liver mass were the 2 most probable differential diagnoses suggested for the mentioned lesion. Ann Surg 179:922925, Seitz K, Strobel D, Bernatik T, et al. This research received no external funding. You may want to read more about NASH here: https://patient.info/health/non-alcoholic-fatty-liver-disease Sonography shows an elliptical mass surrounded by a halo, indicated by the white wedges, in the anterior segment of the right lobe; its internal echogenicity is irregular. https://doi.org/10.3390/curroncol28040265, Lee MCM, Kachura JJ, Vlachou PA, Dzulynsky R, Di Tomaso A, Samawi H, Baxter N, Brezden-Masley C. Evaluation of Adjuvant Chemotherapy-Associated Steatosis (CAS) in Colorectal Cancer. Women were somewhat more affected (56.1%, n=1477) than men (43.9%, n=1154). Following parameters were recorded and evaluated on the basis of the above-mentioned research question: positive/negative finding, nature of tumor, age and gender of the patient, number of foci (solitary, multiple), the respective ultrasound characteristics of the focus and size of the tumor (maximum diameter). For continuous variables, the mean and standard deviation were calculated, while categorical attributes were presented in absolute and relative frequencies. Association between body mass index and fatty liver risk: A dose-response analysis. Unusual patterns of hepatic steatosis caused by the local effect of insulin revealed on chemical shift MR imaging. Kreft, B.P. MRI exhibits the highest sensitivity for detecting hepatic lipid infiltration and can detect as little as 5% steatosis in the liver at a sensitivity of 76.790.0% and a specificity of 87.191% [, Another limitation of this study is the relatively small sample size, particularly for the cohort of patients receiving statins. ; Rinella, M.; Sanyal, A.J. Furthermore, there is currently a lack of medical treatment for any population affected by steatosis, regardless of etiology, although a recently published population-based study suggests that statins may confer protective benefits against the development of steatosis. Other variables included clinical data pertaining to their cancer and variables that may influence steatosis development, such as tumour location, whether primary surgical resection was performed, pelvic radiation status, steroid use, statin use, alcohol consumption, and duration and type of adjuvant chemotherapy received. Areas of focal fatty sparing of the liver adjacent to the gallbladder and porta hepatis, absolute value of liver density less than 40 HU or a density difference greater than 25 HU between the spleen and liver on contrast-enhanced CT, increased echogenicity of the liver, attenuation of the ultrasound wave, loss of definition of the diaphragm, and poor delineation of the intrahepatic architecture on ultrasound and signal drop of liver parenchyma on the T1 weighted out of phase imaging on MRI was considered fatty liver [, A log binomial regression model was used to calculate adjusted relative risks. ; Dobbins, R.; Nuremberg, P.; Horton, J.D. ; Reif, L.J. Check for errors and try again. For example, the prevalence of hepatic hemangioma determined in the studies ranged from 0.1% to 20.0% and that of hepatic cysts from 0.06% to 17.8%. An elliptical mass surrounded by a halo was seen in the anterior segment of the right lobe, and its internal echogenicity was irregular (Fig. Hepatic cysts became more common with age. In addition, many studies on the prevalence of benign space-occupying lesions of the liver were conducted in the 1990s or earlier, i.e., at a time when the image quality of the ultrasound devices used was greatly inferior [17, 2123]. With our determined prevalence of 5.8%, we are also here in the mid-range. 3. The mean size was 39.0mm (Table3). Improved overall survival with oxaliplatin, fluorouracil, and leucovorin and adjuvant treatment in stage II and III colon cancer in the MOSAIC trial. (a) T1-weighted MR images show a wedge-shaped hypointense area, as seen on non-enhanced CT (TR = 316, TE = 11). Current Oncology. (2009) Contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesionsprospective comparison in clinical practice: CEUS vs. CT (DEGUM multicenter trial). The point estimate is consistent with moderately increased risk of steatosis, but with wide confidence intervals (, We then examined the 135 patients who received adjuvant chemotherapy. At the time the article was last revised Raymond Chieng had Through higher performance ultrasound equipment and the introduction of contrast-enhanced ultrasound, the diagnosis of FNH can nowadays be made with higher sensitivity and specificity [31]. (2004) High prevalence of hepatic focal nodular hyperplasia in subjects with hereditary hemorrhagic telangiectasia. Introduction. Correspondence to The treatment for ALD focuses on treating alcohol use disorder. Grieco, A.; Forgione, A.; Miele, L.; Greco, A.V. The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Meunier, L.; Larrey, D. Chemotherapy-associated steatohepatitis. Solitary cysts were found in 62.8% (n=1652) of cases. This study was also limited in that many potentially useful clinical and demographic data such as duration of statin administration and lifestyle factors contributory to steatosis could not be collected due to the retrospective nature of the investigation. Become a Gold Supporter and see no third-party ads. ; Arevalos, E.; Rimm, A.A. Focal hepatic masses and fatty infiltration detected by enhanced dynamic CT. Rofsky, N.M.; Fleishaker, H. CT and MRI of diffuse liver disease. The size and age structure of the respective study populations, as well as the quality of the ultrasound equipment used, need to be considered here. 76.67% (n=1157) of diagnosed hemangiomas were solitary, and the average size of the hemangiomas was 20.1mm. In this study, Stage II-III colorectal cancer patients were retrospectively selected to evaluate the frequency of chemotherapy-associated steatosis and to determine whether patients on statins throughout adjuvant chemotherapy develop chemotherapy-associated steatosis at a lower frequency. In order to be human-readable, please install an RSS reader. The gallbladder is a small, pear-shaped organ on the right side of the belly (abdomen), beneath the liver. In terms of the abnormal finding in the anterior segment, non-enhanced CT suggested focal sparing and sonography suggested a metastatic tumor. Habib, M.B. We use cookies on our website to ensure you get the best experience. If no unequivocal and/or acceptable statements about the above-mentioned parameters could be made from the re-inspected ultrasound images, these were expanded and/or measured again. {"url":"/signup-modal-props.json?lang=us"}, Morgan M, Jones J, Haouimi A, et al. is there a problem of fatty lever? An evidence-based review of statin use in patients with nonalcoholic fatty liver disease. 2001;177(5):1035-9. congenital malformations and anatomical variants. While liver enzymes play a central role in the three-step enzymatic cascade of capecitabine activation to its active metabolite, hepatotoxicity is considered a relatively rare side effect of capecitabine due to its selective activation within the tumor tissue [, Considering the low survival rates of CRC patients in the absence of treatment, adverse effects of CRC chemotherapy have been regarded as inevitable consequences of a necessary life-saving measure. interesting to readers, or important in the respective research area. ; Syrigos, K.N. The research group of Koseoglu reported a prevalence of focal fatty sparing of up to 19.8 [18] Strunk et al. 84.2% (n=16) of patients with adenoma were women. Such atypical cases may simulate neoplasms on CT scans (1,810). Chalasani, N.; Younossi, Z.; Lavine, J.; Diehl, A.M.; Brunt, E.M.; Cusi, K.; Charlton, M.; Sanyal, A.J. Kammen B, Pacharn P, Thoeni R et al. Lawrence, D.A. CAS J Ultrasound Med 14:7780, Karcaaltincaba M, Akhan O (2007) Imaging of hepatic steatosis and fatty sparing. Tanja Eva-Maria Kaltenbach and Phillip Engler have contributed equally to this work. Kratzer et al. Doumas, M.; Imprialos, K.; Dimakopoulou, A.; Stavropoulos, K.; Binas, A.; Athyros, V.G. Wolfgang Kratzer. 2021. https://doi.org/10.3390/curroncol28040265, Lee, Michelle C. M., Jacob J. Kachura, Paraskevi A. Vlachou, Raissa Dzulynsky, Amy Di Tomaso, Haider Samawi, Nancy Baxter, and Christine Brezden-Masley. Several studies on the prevalence of focal liver lesions are primarily concerned with just one individual type of lesion or they investigate the prevalence for a given pre-existing disease [11, 1921]. (2016) Seminars in ultrasound, CT, and MR. 37 (6): 501-510. Fan, R.; Wang, J.; Du, J. Feature papers represent the most advanced research with significant potential for high impact in the field. Advertisement intended for healthcare professionals, For reprints and all correspondence: Motohisa Kato, Second Department of Surgery, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500, Japan. Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive Disclaimer/Publishers Note: The statements, opinions and data contained in all publications are solely ; Gasbarrini, A.; Gasbarrini, G. Fatty liver and drugs. The finding of a FNH or an adenoma is rarely a random discovery. This distribution is the same as that seen in focal fatty sparing and is thought to relate to variations in vascular supply. Despite its frequent association with liver injury, oxaliplatin is classically known to damage the liver via sinusoidal dilation and is thought to have a limited role in inducing steatohepatitis [, Since the FDA approval of capecitabine in 2001 as a chemotherapeutic agent, the oral route of 5-FU delivery became a mainstay of colorectal cancer treatment, alongside intravenous infusion. PubMed Central Slider with three articles shown per slide. Mostbeck GH (1996) Ultrasound screening examination of the abdomen: of value or senseless? AJR Am J Roentgenol 162:11191122, Article The prevalence of FNH was 0.2% (n=81). Google Scholar, Ruiz Guinaldo A, Martn Herrera L, Roldn Cuadra R (1997) Hepatic tumors in patients with cirrhosis: an autopsy study. J Am Soc Echocardiogr 25:553557, Kratzer W, Akinli AS, Bommer M, et al. Since drug-induced hepatotoxicity was described by Grieco et al. Lower prevalence was again determined in the highest age groups. The majority of the more recent ultrasound-based prevalence studies show significantly higher prevalence figures than older ultrasound-based studies (Table4). It may include one or more of the following: supervised medical detox behavioral therapies, such as cognitive behavioral therapy or. Preoperative CT scan and magnetic resonance (MR) imaging in 1993 had shown a slightly fatty liver and no metastasis. 5). Data of 45,319 patients (48.5% women and 51.48% men) were analyzed using a PC-based, standardized documentation system (ViewPoint GE Healthcare GmbH Wessling/Oberpfaffenhofen, Germany). (a) CT arteriogrphy discloses irregular enhancement in the anterior segment, as seen on dynamic MR imaging. He had undergone sigmoidectomy for well differentiated adenocarcinoma of the sigmoid colon on September 2, 1993 in our department. The mean age was 64.7years. Gut 32:677680, Caremani M, Vincenti A, Benci A, Sassoli S, Tacconi D (1993) Ecographic epidemiology of non-parasitic hepatic cysts. It is likely to have different pathogenesis than non-alcoholic steatohepatitis which is a diffuse process. ; MacFarlane, P.W. https://doi.org/10.3390/curroncol28040265, Subscribe to receive issue release notifications and newsletters from MDPI journals, You can make submissions to other journals. This study sought to examine hepatic steatosis, an increasingly recognized health concern worldwide. Lee, M.C.M. Patients with focal fatty sparing are more often male and have a higher BMI and a larger liver than patients with nonalcoholic fatty liver disease without focal fatty sparing. ; Saeian, K.; Lalehzari, M.; Aronsohn, A.; Gorospe, E.C. Diffuse fatty liver is a well recognized entity that is easily diagnosable by computed tomography (CT) or sonography. A characteristic location for focal hepatosteatosis is the medial segment of the left lobe of the liver ( segment 4) either anterior to the porta hepatis or adjacent to the falciform ligament 1. When located in characteristic locations then there is usually little difficulty in making the correct diagnosis. This difference can be related to the population size and age of the patients studied [13, 14]. AJR Am J Roentgenol. St. Michaels Hospital, 30 Bond St, Toronto, ON M5B 1W8, Canada, Medical Sciences Building, 1 Kings College Circle, University of Toronto, Toronto, ON M5S 1A8, Canada, Mount Sinai Hospital, 1284-600 University Avenue, Toronto, ON M5G 1X5, Canada, Lunenfeld-Tanenbaum Research Institute, 600 University Ave, Toronto, ON M5G 1X5, Canada. Between 01/2003 and 11/2013, the liver was examined by ultrasound in a total of 45,319 patients, of whom 48.5% were women (n=21,988) and 51.48% men (n=23331). Editors Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. in 2005, there has been some research on the association between steatosis and anti-tumour drugs, although the precise impacts of CRC chemotherapy have largely been unexplored. ; Laurie, J.A. The most common lesion was focal fatty sparing, which was diagnosed in 2839 cases, corresponding to a prevalence of 6.3%. Pathological examination revealed fibrotic liver tissue adjacent to the tumor; this fibrotic tissue contained fewer fat vacuoles than the rest of the liver parenchyma. permission is required to reuse all or part of the article published by MDPI, including figures and tables. Parts of this manuscript were presented at the Ultrasound Dreilndertreffen 2008, Davos. The role of statins in the management of nonalcoholic fatty liver disease. Am J Clin Pathol 29:160162, Rungsinaporn K, Phaisakamas T (2008) Frequency of abnormalities detected by upper abdominal ultrasound. This distribution is the same as that seen in focal fatty sparing and is thought to relate to variations in vascular supply. analyzed and interpreted the data. This condition, called focal sparing, can occur in diverse patterns. Serum electrolytes, blood urea nitrogen, creatinine, glucose, total bilirubin, alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT), leucine aminopeptidase (LAP) and gamma-glutamyltranspeptidase (g-GTP) were all within the normal ranges. Effects of Statin Use on the Development and Progression of Nonalcoholic Fatty Liver Disease: A Nationwide Nested Case-Control Study. ; Hanafi, I.; Al Zoubi, M.; Bdeir, Z.; Yassin, M.A. Prevention of coronary heart diseases with pravastatin in men with hypercholesterolemia: West of Scotland coronary prevention study group. - 208.97.158.245. ; Compton, C.C. The data are not publicly available due to patient privacy. ; Kramer, J.R.; Richardson, P.A. ; Lawson, T.L. It is a spectrum of disease, ranging from hepatic fat accumulation without inflammation to steatohepatitis, fibrosis, cirrhosis, and end-stage liver disease. Focal fatty infiltration increases the echogenicity of the liver on US images and produces low attenuation on CT images. Hepatocellular carcinoma in the absence of cirrhosis in united states veterans is associated with nonalcoholic fatty liver disease.
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