Imaging of the chemotherapy-induced hepatic damage: Yellow liver, blue liver, and pseudocirrhosis

Figure 7 Focal nodular hyperplasia-like nodules in patients with colorectal cancer treated with surgery and adjuvant chemotherapy. A-C: Six months after adjuvant chemotherapy discontinuation, contrast-enhanced computed tomography (CT) showed a newly appeared nodule in segment II (white arrow), hypodense on unenhanced scan (A), with contrast enhancement on arterial phase (B) without washout in portal phase (C); D-M: Magnetic resonance performed 3 mo after CT showed a volumetric increase in the nodule, characterized by signal hypointensity in gradient echo T1w in-phase (D) and out-of-phase (E) and weak hyperintensity in T2w images (F), without diffusivity restriction on diffusion-weighted imaging (G-H). After liver-specific contrast agent administration, it presented homogeneous wash-in on the arterial phase (J) compared to the unenhanced image (I), no wash-out (K), and weak central signal hypointensity on equilibrium (L) and hepatobiliary (M) phases. A transcutaneous biopsy was performed, resulting in focal nodular hyperplasia-like nodules.