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Chemotherapy-treated liver metastases mimicking hemangiomas on MR images
R C Semelka1, S Worawattanakul, T C Noone
1Department of Radiology, CB 7510, University of North Carolina, Chapel Hill, NC 27599-7510, USA.
Background:
To report the observation that chemotherapy-treated liver metastases may mimic the appearance of hemangiomas on T2-weighted and serial postgadolinium gradient-echo magnetic resonance (MR) images.
Methods:
T2-weighted and serial postgadolinium spoiled gradient-echo images were prospectively and retrospectively analyzed in six patients. All patients had been treated with chemotherapy for a duration of 2-12 months. Histopathologic evaluation of liver lesions was performed in three patients.
Results:
Twelve lesions that resembled hemangiomas were identified. Lesions were 0.8-5.5 cm in diameter. All were well defined, oval or lobulated, and demonstrated decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. On immediate postgadolinium images, all lesions demonstrated peripheral nodular enhancement, which coalesced on delayed imaging. Final histopathologic diagnoses were as follows: hepatic metastases from colon cancer (two patients), ovarian cancer (two patients), pancreatic islet cell tumor (one patient), and breast cancer (one patient).
Conclusions:
Metastases treated by chemotherapy may mimic the appearance of hemangiomas on a variety of commonly employed MR techniques. In patients undergoing MR imaging for the evaluation of liver metastases, a history of prior chemotherapy administration and duration should be sought to prevent inaccurate staging and inappropriate therapeutic decision making.