Serial 1H Magnetic Resonance Spectroscopy Detects Liver Steatosis Associated with Chemotherapy in Advanced Colorectal Cancer Patients

Kristen Zakian¹, Jing Qi¹, Lawrence Schwartz², Yuman Fong³, Leonard Saltz⁴, Nancy Kemeny⁴, Michael D'Angelica³, William Jarnagin³, Jason Koutcher¹

Liver toxicity related to chemotherapy is a growing concern in the combination use of chemo agents. To evaluate the chemotherapy related liver steatosis, serial ¹H MRS was applied to monitor hepatic triglyceride contents changes in 27 colorectal cancer patients during FOLFOX or FUDR/irinotecan treatment. Fat/fat+water ratio (FFW) measured from baseline and post treatment were compared in 17 patients who finished 12 cycle chemotherapy. 9 patients showed increased FFW greater than 15% compared to baseline, indicating chemotherapy associated steatosis. Serial ¹H-MRS quantitatively evaluates the mobilization of liver fat, providing a more accurate way to detect chemo-associated steatosis.