Radiologic Diagnosis of Abdominal Complications of Drug Therapy in Cancer Patients
Abstract
Chemotherapy remains a cornerstone in the treatment of oncologic diseases, evolving from traditional cytotoxic agents to modern targeted and immunotherapeutic strategies. Despite the high efficacy of current antitumor therapies, their use is frequently associated with a high risk of adverse effects resulting from systemic and local impacts on various organs and tissues. The liver, pancreas, and biliary tract are particularly susceptible to toxic injury due to their critical metabolic functions and heightened sensitivity to microenvironmental changes. Imaging modalities, such as ultrasonography, computed tomography, and magnetic resonance imaging, play a key role in the detection and monitoring of treatment-related complications. These techniques enable timely identification and comprehensive assessment of pathological changes within the hepatobiliary system and pancreas. Typical imaging manifestations associated with antitumor therapy include sinusoidal obstruction syndrome, hepatic steatosis, pseudocirrhosis, drug-induced hepatitis, pancreatitis, pancreatic atrophy, biliary fibrosis, and cholangitis.
About the Authors
N. V. Agurina
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Natalia V. Agurina, Radiologist, Radiology Department; Assistant Professor, Radiology Department No. 2
Krasnodar
E. G. Shevchenko
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Evgeniya G. Shevchenko, Radiologist, Radiology Department; Assistant Professor, Radiology Department No. 2
Krasnodar
E. I. Zyablova
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Elena I. Zyablova, Dr. Sci. (Med.), Assoc. Prof., Head of the Department of Radiology No. 2; Chief Radiologist of Krasnodar Krai
167 1 Maya St., Krasnodar, 350086
References
1. Зяблова Е.И. Визуализация побочных эффектов противоопухолевой терапии: монография/ Е.И. Зяблова; ГБУЗ «Науч.-исслед. ин-т «Краев. клин. больница №1 им. С.В. Очаповского» М-ва здравоохранения Краснодар. края, ФГОБУ ВО «Кубан. гос. мед. ун-т» М-ва здравоохранения Рос. Федерации. – Краснодар: Печатный двор Кубани, 2025. – 156 с. ISBN 978-5-6-50730-2-4
2. Зяблова Е.И., Агурина Н.В., Порханов В.А. Значение КТ в диагностике колита как осложнения терапевтического лечения онкологических пациентов. Инновационная медицина Кубани. 2025;10(2):127-134. https://doi.org/10.35401/2541-9897-2025-10-2-127-134
3. Зяблова Е.И, Нефедова Л.Н., Порханов В.А. Лучевая диагностика иммунотерапевтических осложнений. Онкологический журнал: лучевая диагностика, лучевая терапия. 2020;3(3):44-53. DOI: 10.37174/2587-7593-2020-3-3-44-53
4. Ройтберг Г.Е., Синицын В.Е., Кондратова Н.В., Струтынский В.А.,Платонова О.Е., Дорош Ж.В. Возможность прогнозирования отдаленных результатов таргетной терапии у пациентов с НМРЛ и мутацией в гене EGFR с помощью ПЭТ/КТ с 18F-ФДГ. REJR 2024; 14(4):69-79. DOI: 10.21569/2222-7415-2024-14-4-69-79.
5. Ngo D, Jia JB, Green CS, Gulati AT, Lall C. Cancer therapy related complications in the liver, pancreas, and biliary system: an imaging perspective. Insights Imaging. 2015 Dec;6(6):665-77. doi: 10.1007/s13244-015-0436-7. Epub 2015 Oct 6. PMID: 26443452; PMCID: PMC4656242.
6. Viswanathan C, Truong MT, Sagebiel TL, Bronstein Y, Vikram R, Patnana M, Silverman PM, Bhosale PR. Abdominal and pelvic complications of nonoperative oncologic therapy. Radiographics. 2014 Jul-Aug;34(4):941-61. doi: 10.1148/rg.344140082. PMID: 25019433.
7. Torrisi JM, Schwartz LH, Gollub MJ, Ginsberg MS, Bosl GJ, Hricak H. CT findings of chemotherapy-induced toxicity: what radiologists need to know about the clinical and radiologic manifestations of chemotherapy toxicity. Radiology. 2011 Jan;258(1):41- 56. doi: 10.1148/radiol.10092129. PMID: 21183492.
8. Shanbhogue AK, Virmani V, Vikram R, Prasad SR, Shanbhogue DK, Nagar A, Fasih N. Spectrum of medication-induced complications in the abdomen: role of cross-sectional imaging. AJR Am J Roentgenol. 2011 Aug;197(2):W286-94. doi: 10.2214/AJR.10.5415. PMID: 21785055.
9. Pozzessere C, Mazini B, Omoumi P, Jreige M, Noirez L, Digklia A, Fasquelle F, Sempoux C, Dromain C. Immune-Related Adverse Events Induced by Immune Checkpoint Inhibitors and CAR-T Cell Therapy: A Comprehensive Imaging-Based Review. Cancers (Basel). 2024 Jul 19;16(14):2585. doi: 10.3390/cancers16142585. PMID: 39061225; PMCID: PMC11274393.
10. Kusakabe A, Ohkawa K, Fukutake N, Sakakibara M, Imai T, Abe Y, Takada R, Ikezawa K, Nawa T, Ashida R, Kimura T, Nagata S, Katayama K. Chemotherapy-Induced Sclerosing Cholangitis Caused by Systemic Chemotherapy. ACG Case Rep J. 2019 Jul 17;6(7): e00136. doi: 10.14309/crj.0000000000000136. PMID: 31620533; PMCID: PMC6722363.
11. Fujiwara Y, Yamaguchi T, Nakane M. Portal Vein Thrombosis in Metastatic Colorectal Cancer During FOLFIRI-bevacizumab Chemotherapy Successfully Treated with Apixaban. Intern Med. 2021 Jan 1;60(1):53-57. doi: 10.2169/internalmedicine.5456-20. Epub 2020 Aug 12. PMID: 32788527; PMCID: PMC7835470.
12. Nakano R, Shiomi H, Fujiwara A, Yoshihara K, Yoshioka R, Kawata S, Ota S, Yuri Y, Takashima T, Aizawa N, Ikeda N, Nishimura T, Enomoto H, Iijima H. Clinical Characteristics of ICIRelated Pancreatitis and Cholangitis Including Radiographic and Endoscopic Findings. Healthcare (Basel). 2022 Apr 20;10(5):763. doi: 10.3390/healthcare10050763. PMID: 35627900; PMCID: PMC9140598.
13. Ashfaq A, Thalambedu N, Atiq MU. Acute Pancreatitis Secondary to Pembrolizumab-Induced Hypertriglyceridemia. Cureus. 2023 Apr 29;15(4):e38315. doi: 10.7759/cureus.38315. PMID: 37261185; PMCID: PMC10227188.
14. Khamaysi I, Hajj E. Drug-induced Pancreatic Atrophy (“The Vanishing Pancreas”). Euroasian J Hepatogastroenterol. 2020 Jul-Dec;10(2):101-102. doi: 10.5005/jp-journals-10018-1323. PMID: 33511073; PMCID: PMC7801894.
Review
For citations:
Agurina N.V., Shevchenko E.G., Zyablova E.I. Radiologic Diagnosis of Abdominal Complications of Drug Therapy in Cancer Patients. Innovative Medicine of Kuban. 2026;11(1-1):27-36. (In Russ.)
Views:
128
JATS XML
Email this article 
