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Ding Y, Rao SX, Wang WT, Chen CZ, Li RC, Zeng M. Gd-EOB-DTPA-enhanced MR findings in chemotherapy-induced sinusoidal obstruction syndrome in colorectal liver metastases. J Int Med Res 2021; 48:300060520926031. [PMID: 32500783 PMCID: PMC7278311 DOI: 10.1177/0300060520926031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background We assessed the clinical presentations, biomarkers, and Gd-EOB-DTPA-enhanced MRI features that were associated with oxaliplatin-induced sinusoidal obstruction syndrome (SOS) to detect chemotherapy-associated SOS in a timely manner. Methods Fifty-seven patients who underwent oxaliplatin-based chemotherapy and Gd-EOB-DTPA-enhanced MRI were included. Post-oxaliplatin heterogeneity in liver parenchyma was scored on a grading scale of 0 to 3. Abnormal clinical findings, including splenomegaly, hepatomegaly, gall bladder wall thickening, and hepatic vein narrowing, were also assessed. Additionally, alanine transaminase (ALT) levels, aspartate aminotransferase (AST) levels, and platelet counts were measured. Results For SOS, 21 patients were scored grade 0, 24 were grade 1, seven were grade 2, and five were grade 3. Hepatomegaly, splenomegaly, gall bladder wall thickening, and hepatic vein narrowing were significantly correlated with the grade for non-tumorous hepatic parenchymal heterogeneity. For laboratory findings, ALT and AST levels, the AST-to-platelet ratio index score, and platelet counts were significantly associated with a high grade (≥2) of non-tumorous hepatic parenchymal heterogeneity. Conclusions We assessed the clinical presentations, biomarkers, and Gd-EOB-DTPA-enhanced MRI features that were associated with oxaliplatin-induced sinusoidal obstruction syndrome (SOS) to detect chemotherapy-associated SOS in a timely manner. Additionally, specific laboratory findings were significantly associated with a high grade (≥2).
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Affiliation(s)
- Ying Ding
- Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Sheng-Xiang Rao
- Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Wen-Tao Wang
- Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Cai-Zhong Chen
- Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Ren-Chen Li
- Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai, China
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Lyu J, Yang G, Mei Y, Guo L, Guo Y, Zhang X, Xu Y, Feng Y. Non-Gaussian Diffusion Models and T 1 rho Quantification in the Assessment of Hepatic Sinusoidal Obstruction Syndrome in Rats. J Magn Reson Imaging 2020; 52:1110-1121. [PMID: 32246796 DOI: 10.1002/jmri.27156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Non-Gaussian diffusion models and T1 rho quantification may reflect the changes in tissue heterogeneity in hepatic sinusoidal obstruction syndrome (SOS). PURPOSE To investigate the feasibility of diffusion kurtosis imaging (DKI), stretched exponential model (SEM), and T1 rho quantification in detecting and staging SOS in a monocrotaline (MCT)-induced rat model. STUDY TYPE Animal study. POPULATION Thirty male Sprague-Dawley rats gavaged with MCT to induce hepatic SOS and six male rats without any intervention. FIELD STRENGTH/SEQUENCE 3.0T, DWI with five b-values (0-2000 s/mm2 ) and T1 rho with five spin lock times (1-60 msec). ASSESSMENT MRI was performed 1 day before and 1, 3, 5, 7, and 10 days after MCT administration. The corrected apparent diffusion coefficient (Dapp ), kurtosis coefficient (Kapp ), distributed diffusion coefficient (DDC), and intravoxel water molecular diffusion heterogeneity (α) were calculated from the corresponding non-Gaussian diffusion model. The T1 rho value was calculated using a monoexponential model. Specimens obtained from the six timepoints were categorized into normal liver (n = 6), early-stage (n = 16), and late-stage (n = 14) SOS in accordance with the pathological score. STATISTICAL TESTS Parametric statistical methods and receiver operating characteristic (ROC) curves were employed to determine diagnostic accuracy. RESULTS The Dapp , Kapp , DDC, α, and T1 rho values were correlated with pathological score with r values of -0.821, 0.726, -0.828, -0.739, and 0.714 (all P < 0.001), respectively. DKI (combined Dapp and Kapp ) and SEM (combined DDC and α) were better than T1 rho for staging SOS. The areas under the ROC curve of DKI, SEM, and T1 rho for differentiating normal liver and early-stage SOS were 0.97, 1.00, and 0.79, whereas those of DKI, SEM, and T1 rho for differentiating early-stage and late-stage SOS were 1.00, 0.97, and 0.92, respectively. DATA CONCLUSION DKI, SEM, and T1 rho may be helpful in staging SOS. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 2 J. Magn. Reson. Imaging 2020;52:1110-1121.
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Affiliation(s)
- Jian Lyu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Guixiang Yang
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, Guangdong, China
| | - Yingjie Mei
- Philips Healthcare, Guangzhou, Guangdong, China
| | - Li Guo
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China.,Department of MRI, The First People's Hospital of Foshan (Affiliated Foshan Hospital of Sun Yat-sen University), Foshan, Guangdong, China
| | - Yihao Guo
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinyuan Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
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Botti S, Agreiter I, Orlando L, Gargiulo G, Bonifazi F, Banfi MM, Cappucciati L, Caffarri C, De Cecco V, Deiana GM, Gavezzotti M, Magarò A, Netti MG, Pignatelli AC, Rostagno E, Samarani E, Cardoso JS, Soave S, Valente CM, Vedovetto A, Zecca M, Luminari S, Merli F, Guberti M. Nursing role in the assessment and care of hepatic sinusoidal obstruction syndrome patients: a consensus paper by the "Gruppo Italiano Trapianto di Midollo Osseo". Support Care Cancer 2020; 28:5125-5137. [PMID: 32056012 DOI: 10.1007/s00520-020-05353-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/06/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Sinusoidal obstruction syndrome (SOS) is one of the most serious complications post haematopoietic stem cell transplantation (HSCT). The diagnosis of SOS is clinical, but nurses should be involved in the pre-transplant risk assessment period and play a crucial role in the early detection of signs and symptoms during and after hospitalization. The aim of this work is to achieve a consensus on nurses' behaviour in caring for SOS. METHODS On behalf of the Italian Group for Bone and Marrow Transplantation (GITMO), a promoter committee was established to put in place a consensus conference approach. A multidisciplinary group of GITMO together with four nurses, three haematology physicians and one patient representative acted as jury, who reviewed the reports and wrote recommendations and suggestions. Recommendations gaining 100% of consensus were considered 'Golden Points of Care'; if a consensus was achieved by ≥ 75% of the jury's members, those recommendations were defined as 'Good Practices'. RESULTS Eighteen papers written by nurses as first authors have been identified. Golden Points of Care and Good Practices were worked out for the following topics: nurses' role in general, nurses' role in pre-transplant assessment, pre-transplant risk assessment and risk stratification, baseline monitoring, suspected mild or moderate SOS, suspected severe or very severe SOS and late-onset cases. CONCLUSION SOS is relatively rare; therefore, a holistic approach to the patients' needs considering nursing role as essential may result in better care outcomes.
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Affiliation(s)
- Stefano Botti
- Haematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Iris Agreiter
- Bone Marrow Transplant Unit Denis Burkitt, St. James's Hospital, Dublin, Ireland
| | - Laura Orlando
- Bone Marrow Transplant Unit, Istituto Oncologico Svizzera Italiana, Bellinzona, Switzerland
| | - Gianpaolo Gargiulo
- Haematology Unit, Federico II University Hospital of Naples, Naples, Italy
| | - Francesca Bonifazi
- Institute of Haematology "Seràgnoli", University Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Marina Marialuisa Banfi
- Bone Marrow Transplant Unit, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Lorella Cappucciati
- Department of Haematology, Guglielmo da Saliceto Hospital Piacenza, Piacenza, Italy
| | - Cristiana Caffarri
- Haematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valentina De Cecco
- Paediatric Haematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Marta Gavezzotti
- Haematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Magarò
- Division of Haemato-oncology, European Institute of Oncology Milan, Milan, Italy
| | - Maria Giovanna Netti
- Department of Pediatric Oncology, Neuro-Oncology Unit, Meyer Children's University Hospital Florence, Florence, Italy
| | | | - Elena Rostagno
- Paediatric Haemato-oncology and BMT Department, Azienda Ospedaliero, Universitaria S. Orsola Malpighi, Bologna, Italy
| | | | | | - Sonia Soave
- Stem Cell Transplant Unit, Department of Hematology, Tor Vergata "University Hospital" Rome, Rome, Italy
| | | | - Alessio Vedovetto
- Health Profession Direction, Nursing Course University of Padova, Padua, Italy
| | - Marco Zecca
- Paediatric Haematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Luminari
- Haematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Merli
- Haematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Monica Guberti
- Health Professions Direction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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