{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:08:50Z","timestamp":1784297330840,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Sinusoidal obstruction syndrome (SOS), also known as \u201cblue liver (BL),\u201d is a common hepatic injury following oxaliplatin\u2010based chemotherapy in patients with colorectal liver metastases (CRLM). Early non\u2010invasive identification of SOS is essential for safe hepatic resection and improved outcomes; however, this remains clinically challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 155 patients who underwent preoperative ethoxybenzyl\u2010diethylenetriamine pentaacetic acid\u2010enhanced magnetic resonance imaging (EOB\u2010MRI) and hepatic resection for CRLM between 2014 and 2022. Radiologists evaluated SOS on EOB\u2010MRI using a five\u2010point reticular signal grading scale. Aspartate aminotransferase to platelet ratio index (APRI) scores were calculated preoperatively. BL was confirmed intraoperatively based on characteristic liver discoloration. Correlations between EOB\u2010MRI scores, APRI, and clinical outcomes were analyzed using receiver operating characteristic curves, survival analysis, and multivariate statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 70 patients treated with preoperative oxaliplatin, 25 (35.7%) exhibited intraoperative BL. Overall survival was significantly worse in the blue liver group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0338), although disease\u2010free survival did not differ significantly. Patients in the BL group had significantly higher APRI and EOB\u2010MRI scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0028 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001, respectively). The combined EOB\u2010MRI assessment and APRI had the highest diagnostic ability for BL detection, yielding an area under the curve of 0.806, with 78.0% sensitivity and 67.7% specificity. Patients with high scores in both modalities exhibited significantly poorer overall survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A combination of EOB\u2010MRI and APRI is a valuable non\u2010invasive tool for preoperative detection of SOS in patients with CRLM. This approach improves diagnostic accuracy, facilitates surgical planning, and may predict long\u2010term prognosis following hepatic resection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70092","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T11:10:22Z","timestamp":1757416222000},"page":"548-558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combination of Ethoxybenzyl\u2010Diethylenetriamine Pentaacetic Acid\u2010Enhanced Magnetic Resonance Imaging and a Serum Biomarker Is Useful in the Diagnosis of Hepatic Sinusoidal Disorder After Chemotherapy Treatment"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7257-3586","authenticated-orcid":false,"given":"Tomonari","family":"Shimagaki","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery NHO Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8768-5388","authenticated-orcid":false,"given":"Keishi","family":"Sugimachi","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery NHO Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Tomino","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery NHO Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery NHO Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery NHO Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Shimomura","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging and Nuclear Medicine NHO Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Shinozaki","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging and Nuclear Medicine NHO Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery NHO Kyushu Cancer Center  Fukuoka 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