Imaging of the chemotherapy-induced hepatic damage: Yellow liver, blue liver, and pseudocirrhosis

Figure 6 Association between sinusoidal obstructive syndrome and peliosis in patients without a history of hepatopathy, with lung cancer treated with 3 cycles of cisplatin and etoposide and 12 subsequent cycles of immunotherapy. A-K: After 1 year of therapy, magnetic resonance was performed for abdominal pain and an increase in liver enzymes. Hyperintense nodules on T2w (A), T2w fat sat (B) and high b-value diffusion-weighted images (C) are seen. On the apparent diffusion coefficient map (D), they are hypointense. On dynamic imaging, weak enhancement is seen (E: Unenhanced image; F, G, H: Arterial, portal and equilibrium phases, respectively). In the hepatobiliary phase, they appear predominantly hypointense (I-K). A transcutaneous biopsy was performed, resulting in peliosis nodules. Mosaic pattern enhancement of the liver parenchyma in the arterial phase (F) and reticular aspects in the hepatobiliary phase (I-J) were consistent with sinusoidal obstructive syndrome.