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Effects of Tamoxifen on Hepatic Fat Content and the Development of Hepatic Steatosis in Patients with Breast Cancer: High Frequency of Involvement and Rapid Reversal After Completion of Tamoxifen Therapy

Mizuki Nishino1, Katsumi Hayakawa1, Yoshiaki Nakamura2, Taisuke Morimoto2 and Sumio Mukaihara2

1 Department of Radiology, Kyoto City Hospital, 1-2 Higashi-takada-cho, Mibu, Nakagyo-ku, Kyoto 604-8845, Japan.
2 Department of Surgery, Kyoto City Hospital, Kyoto 604-8845, Japan.



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  		Fig. 1. —Chart shows mean hepatic CT attenuation values of all patients throughout study. Among mean CT attenuation values of liver obtained each year while patients were undergoing tamoxifen therapy, lowest value was used as "During" (p < 0.0001, paired t test). Each color represents a different patient.

 


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  		Fig. 2A. —55-year-old woman with representative CT findings of transient hepatic steatosis. Unenhanced abdominal CT image obtained before tamoxifen therapy shows normal homogeneous CT attenuation of liver, which is slightly higher than that of spleen. Liver—spleen ratio was 1.3.

 


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  		Fig. 2B. —55-year-old woman with representative CT findings of transient hepatic steatosis. Unenhanced abdominal CT image obtained after 1 year of tamoxifen therapy shows decrease in CT attenuation of liver predominantly in right lobe, with liver—spleen ratio of 0.3. Note development of moderate hepatic steatosis.

 


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  		Fig. 2C. —55-year-old woman with representative CT findings of transient hepatic steatosis. Unenhanced abdominal CT image obtained after 2 years of tamoxifen therapy shows further decrease in CT attenuation of liver in right lobe, with liver—spleen ratio of 0.1. Degree of steatosis is still moderate.

 


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  		Fig. 2D. —55-year-old woman with representative CT findings of transient hepatic steatosis. Unenhanced abdominal CT image obtained 1 year after completion of tamoxifen therapy shows that CT attenuation of liver has returned to normal, with liver—spleen ratio of 1.1. Steatosis is not present.

 


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  		Fig. 3. —Chart shows liver—spleen ratio in 29 patients with hepatic steatosis before, during, and after tamoxifen therapy. Liver—spleen ratio was calculated using lowest CT attenuation value of liver among values in the eight Couinaud segments. Each color represents a different patient.

 

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