Serial measurement of hepatic lipids during chemotherapy in patients with colorectal cancer: A 1H MRS study Journal Article


Authors: Qi, J.; Fong, Y.; Saltz, L.; D'Angelica, M. I.; Kemeny, N. E.; Gonen, M.; Shia, J.; Shukla-Dave, A.; Jarnagin, W.; Do, R. K. G.; Schwartz, L. H.; Koutcher, J. A.; Zakian, K. L.
Article Title: Serial measurement of hepatic lipids during chemotherapy in patients with colorectal cancer: A 1H MRS study
Abstract: Hepatic steatosis is a hallmark of chemotherapy-induced liver injury. We made serial 1H MRS measurements of hepatic lipids in patients over the time course of a 24-week chemotherapeutic regimen to determine whether 1H MRS could be used to monitor the progression of chemotherapy-induced steatosis. Thirty-four patients with stage III or IV colorectal cancer receiving 5-fluorouracil, folinic acid and oxaliplatin (n=21) or hepatic arterial infusion of floxuridine with systemic irinotecan (n=13) were studied prospectively. 1H MRS studies were performed at baseline and after 6 and 24weeks of treatment. A 1H MR spectrum was acquired from the liver during a breath hold and the ratio of fat to fat+water (FFW) was calculated to give a measure of hepatic triglycerides (HTGCs). The methodology was histologically validated in 18 patients and the reproducibility was assessed in 16 normal volunteers. Twenty-seven patients completed baseline, 6-week and 24-week 1H MRS examinations and one was censored. Thirteen of 26 patients (50%) showed an increase in FFW after completion of treatment. Six patients (23%) developed hepatic steatosis and two patients converted from steatosis to nonsteatotic liver. Patients whose 6-week hepatic lipid levels had increased significantly relative to baseline also had a high probability of lipid elevation relative to baseline at the completion of treatment. Serial 1H MRS is effective for the monitoring of HTGC changes during chemotherapy and for the detection of chemotherapy-associated steatosis. Six of 26 patients developed steatosis during chemotherapy. Lipid changes were observable at 6weeks. © 2012 John Wiley & Sons, Ltd.
Keywords: liver; imaging; steatosis; fat; folfox
Journal Title: NMR in Biomedicine
Volume: 26
Issue: 2
ISSN: 0952-3480
Publisher: John Wiley & Sons  
Date Published: 2013-02-01
Start Page: 204
End Page: 212
Language: English
DOI: 10.1002/nbm.2837
PROVIDER: scopus
PMCID: PMC3519948
PUBMED: 22961714
DOI/URL:
Notes: --- - "Export Date: 1 February 2013" - "CODEN: NMRBE" - "Source: Scopus"
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MSK Authors
  1. Leonard B Saltz
    792 Saltz
  2. Mithat Gonen
    1032 Gonen
  3. Jinru Shia
    720 Shia
  4. William R Jarnagin
    908 Jarnagin
  5. Kinh Gian Do
    258 Do
  6. Yuman Fong
    775 Fong
  7. Amita Dave
    140 Dave
  8. Kristen L Zakian
    82 Zakian
  9. Jason A Koutcher
    278 Koutcher
  10. Jing Qi
    2 Qi
  11. Nancy Kemeny
    545 Kemeny