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Published in: Journal of Medical Case Reports 1/2008

Open Access 01-12-2008 | Case report

Distinguishing post-treatment changes from recurrent disease in cholangiocarcinoma: a case report

Authors: Timothy N Showalter, A Omer Nawaz, Frederick M Fellin, Pramila R Anne, Ernest L Rosato, Adam P Dicker

Published in: Journal of Medical Case Reports | Issue 1/2008

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Abstract

Introduction

Three-dimensional techniques for radiotherapy have expanded possibilities for partial volume liver radiotherapy. Characteristic, transient radiographic changes can occur in the absence of clinical radiation-induced liver disease after hepatic radiotherapy and must be distinguished from local recurrence.

Case presentation

In this report, we describe computed tomography changes after chemoradiotherapy for cholangiocarcinoma as an example of collaboration to determine the clinical significance of the radiographic finding.

Conclusion

Because of improved three-dimensional, conformal radiotherapy techniques, consultation across disciplines may be necessary to interpret post-treatment imaging findings.
Appendix
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Literature
1.
go back to reference Lawrence TS, Robertson JM, Anscher MS, Jirtle RL, Ensminger WD, Fajardo LF: Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys. 1995, 31: 1237-1248.CrossRefPubMed Lawrence TS, Robertson JM, Anscher MS, Jirtle RL, Ensminger WD, Fajardo LF: Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys. 1995, 31: 1237-1248.CrossRefPubMed
2.
go back to reference Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M: Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991, 21: 109-122.CrossRefPubMed Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M: Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991, 21: 109-122.CrossRefPubMed
3.
go back to reference Wharton JT, Delclos L, Gallager S, Smith JP: Radiation hepatitis induced by abdominal irradiation with the cobalt 60 moving strip technique. Am J Roentgenol Radium Ther Nucl Med. 1973, 117: 73-80.CrossRefPubMed Wharton JT, Delclos L, Gallager S, Smith JP: Radiation hepatitis induced by abdominal irradiation with the cobalt 60 moving strip technique. Am J Roentgenol Radium Ther Nucl Med. 1973, 117: 73-80.CrossRefPubMed
4.
go back to reference Dawson LA, Ten Haken RK: Partial volume tolerance of the liver to radiation. Sem Radiat Oncol. 2005, 15: 279-283. 10.1016/j.semradonc.2005.04.005.CrossRef Dawson LA, Ten Haken RK: Partial volume tolerance of the liver to radiation. Sem Radiat Oncol. 2005, 15: 279-283. 10.1016/j.semradonc.2005.04.005.CrossRef
5.
go back to reference Yamasaki SA, Marn CS, Francis IR, Robertson JM, Lawrence TS: High-dose localized radiation therapy for treatment of hepatic malignant tumors: CT findings and their relation to radiation hepatitis. AJR Am J Roentgenol. 1995, 165: 79-84.CrossRefPubMed Yamasaki SA, Marn CS, Francis IR, Robertson JM, Lawrence TS: High-dose localized radiation therapy for treatment of hepatic malignant tumors: CT findings and their relation to radiation hepatitis. AJR Am J Roentgenol. 1995, 165: 79-84.CrossRefPubMed
6.
go back to reference Jeffrey RB, Moss AA, Quivey JM, Federle MP, Wara WM: CT of radiation-induced hepatic injury. AJR Am J Roentgenol. 1980, 135: 445-448.CrossRefPubMed Jeffrey RB, Moss AA, Quivey JM, Federle MP, Wara WM: CT of radiation-induced hepatic injury. AJR Am J Roentgenol. 1980, 135: 445-448.CrossRefPubMed
7.
go back to reference Willemart S, Nicaise N, Struyven J, van Gansbeke D: Acute radiation-induced hepatic injury: evaluation by triphasic contrast enhanced helical CT. Br J Radiol. 2000, 73: 544-546.CrossRefPubMed Willemart S, Nicaise N, Struyven J, van Gansbeke D: Acute radiation-induced hepatic injury: evaluation by triphasic contrast enhanced helical CT. Br J Radiol. 2000, 73: 544-546.CrossRefPubMed
8.
go back to reference Munden RF, Erasmus JJ, Smythe WR, Madewell JE, Forster KM, Stevens CW: Radiation injury to the liver after intensity-modulated radiation therapy in patients with mesothelioma: an unusual CT appearance. AJR Am J Roentgenol. 2005, 184: 1091-1095.CrossRefPubMed Munden RF, Erasmus JJ, Smythe WR, Madewell JE, Forster KM, Stevens CW: Radiation injury to the liver after intensity-modulated radiation therapy in patients with mesothelioma: an unusual CT appearance. AJR Am J Roentgenol. 2005, 184: 1091-1095.CrossRefPubMed
10.
go back to reference Ogata K, Hizawa K, Yoshida M, Kitamuro T, Akagi G, Kagawa K, Fukuda F: Hepatic injury following irradiation – a morphologic study. Tokushima J Exp Med. 1963, 9: 240-251. Ogata K, Hizawa K, Yoshida M, Kitamuro T, Akagi G, Kagawa K, Fukuda F: Hepatic injury following irradiation – a morphologic study. Tokushima J Exp Med. 1963, 9: 240-251.
11.
go back to reference Lawrence TS, Ten Haken RK, Kessler ML, Robertson JM, Lyman JT, Lavigne ML, Brown MB, DuRoss DJ, Andrews JC, Ensminger WD, Lichter AS: The use of 3-D dose volume analysis to predict radiation hepatitis. Int J Radiat Oncol Biol Phys. 1992, 23: 781-788.CrossRefPubMed Lawrence TS, Ten Haken RK, Kessler ML, Robertson JM, Lyman JT, Lavigne ML, Brown MB, DuRoss DJ, Andrews JC, Ensminger WD, Lichter AS: The use of 3-D dose volume analysis to predict radiation hepatitis. Int J Radiat Oncol Biol Phys. 1992, 23: 781-788.CrossRefPubMed
12.
go back to reference Dawson LA, Normolle D, Balter JM, McGinn CJ, Lawrence TS, Ten Haken RK: Analysis of radiation-induced liver disease using the Lyman NTCP model. Int J Radiat Oncol Biol Phys. 2002, 53: 810-821.CrossRefPubMed Dawson LA, Normolle D, Balter JM, McGinn CJ, Lawrence TS, Ten Haken RK: Analysis of radiation-induced liver disease using the Lyman NTCP model. Int J Radiat Oncol Biol Phys. 2002, 53: 810-821.CrossRefPubMed
13.
go back to reference Onaya H, Itai Y, Ahmadi T, Yoshioka H, Okumura T, Akine Y, Tsuji H, Tsujii H: Recurrent hepatocellular carcinoma versus radiation-induced hepatic injury: differential diagnosis with MR imaging. Magn Reson Imaging. 2001, 19: 41-46. 10.1016/S0730-725X(01)00218-1.CrossRefPubMed Onaya H, Itai Y, Ahmadi T, Yoshioka H, Okumura T, Akine Y, Tsuji H, Tsujii H: Recurrent hepatocellular carcinoma versus radiation-induced hepatic injury: differential diagnosis with MR imaging. Magn Reson Imaging. 2001, 19: 41-46. 10.1016/S0730-725X(01)00218-1.CrossRefPubMed
14.
go back to reference Garra BS, Shawker TH, Chang R, Kaplan K, White RD: The ultrasound appearance of radiation-induced hepatic injury: correlation with computed tomography and magnetic resonanace imaging. J Ultrasound Med. 1988, 7: 605-609.PubMed Garra BS, Shawker TH, Chang R, Kaplan K, White RD: The ultrasound appearance of radiation-induced hepatic injury: correlation with computed tomography and magnetic resonanace imaging. J Ultrasound Med. 1988, 7: 605-609.PubMed
15.
go back to reference Padhani AR, Husband JE, Gueret Wardle D: Radiation induced liver injury detected by particulate reticuloendothelial contrast agent. Br J Radiol. 1998, 71: 1089-1092.CrossRefPubMed Padhani AR, Husband JE, Gueret Wardle D: Radiation induced liver injury detected by particulate reticuloendothelial contrast agent. Br J Radiol. 1998, 71: 1089-1092.CrossRefPubMed
Metadata
Title
Distinguishing post-treatment changes from recurrent disease in cholangiocarcinoma: a case report
Authors
Timothy N Showalter
A Omer Nawaz
Frederick M Fellin
Pramila R Anne
Ernest L Rosato
Adam P Dicker
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2008
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-2-76

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