Chemotherapy-associated liver morphological changes in hepatic metastases (CALMCHeM)

Area of Science:

• Radiology
• Oncology
• Hepatology

Background:

• Chemotherapy can induce significant morphological changes in the liver, particularly in patients with hepatic metastases.
• Understanding these changes is crucial for accurate interpretation of imaging findings and patient management.

Purpose of the Study:

• To review imaging findings of chemotherapy-associated liver morphological changes in hepatic metastases (CALMCHeM) on CT/MRI.
• To assess the association between these morphological changes and the initial tumor burden.

Main Methods:

• Retrospective review of CT/MRI in 219 patients with hepatic metastases who received chemotherapy.
• Morphological changes assessed included nodularity, capsular retraction, fibrotic bands, lobulated outline, atrophy/hypertrophy, widened fissures, and signs of portal hypertension.
• Tumor burden graded by number, lobar distribution, and liver volume affected; CALMCHeM severity graded qualitatively.

Main Results:

• CALMCHeM severity correlated with a larger number of metastases (P=0.002) and greater liver volume affected (P=0.015).
• Moderate to severe CALMCHeM changes observed in 85.9% of patients; 72.5% showed portal hypertension features.
• Metastases affecting ≥50% of the liver and female gender were independently associated with severe CALMCHeM.

Conclusions:

• Chemotherapy-associated liver morphological changes occur across various malignancies and tend to progress.
• The severity of CALMCHeM is linked to the initial burden of metastatic liver disease.
• Imaging plays a key role in identifying and monitoring these treatment-related liver changes.