Objectives

To describe the major advances in detection, follow-up and treatment of liver metastasis and review the applications and limitations of the avaiable imaging modalities through out clinical cases.

Background

Metastasis are the most common malignant liver lesions and the most common indication for hepatic imaging.

CT is the modality of choice for evaluating liver metastasis. However, evidence supporting the use of MRI in the evaluation of liver metastasis is accumulating because MRI allows the effective localization of hepatic and vascular invasion.

The sensitivity of FDG-PET has been found to be equal or superior to that of both CT and MRI. Furthermore, FDG-PET has been found to be able to detect extrahepatic metastasis that were could be missed.

US is an inexpensive readily available modality but has largely been supplanted by CT, but intraoperative ultrasound of the liver has the highest sensitivity for the detection of focal liver abnormalities.

However, as the therapeutic models evolved and became more accurate and individualized, imaging diagnostics had to become more sensitive and dynamic to handle the new complex management.

Imaging findings OR Procedure findings

In this study, we will update the imaging, management and treatment of the liver metastases by using illustrated examples in a case-based review. We will explore the CT, MR, PET-CT and intraoperative US imaging, including abbreviated MRI protocols, and also some brand new techniques that could allow a better management of the hepatic metastasis.

Conclusion

Optimal detection and characterization of liver metastases can alter patient management and the imaging methods play an fundamental role in this cenario.

Objectives

To describe the major advances in detection, follow-up and treatment of liver metastasis and review the applications and limitations of the avaiable imaging modalities through out clinical cases.

Background

Metastasis are the most common malignant liver lesions and the most common indication for hepatic imaging.

CT is the modality of choice for evaluating liver metastasis. However, evidence supporting the use of MRI in the evaluation of liver metastasis is accumulating because MRI allows the effective localization of hepatic and vascular invasion.

The sensitivity of FDG-PET has been found to be equal or superior to that of both CT and MRI. Furthermore, FDG-PET has been found to be able to detect extrahepatic metastasis that were could be missed.

US is an inexpensive readily available modality but has largely been supplanted by CT, but intraoperative ultrasound of the liver has the highest sensitivity for the detection of focal liver abnormalities.

However, as the therapeutic models evolved and became more accurate and individualized, imaging diagnostics had to become more sensitive and dynamic to handle the new complex management.

Imaging findings OR Procedure findings

In this study, we will update the imaging, management and treatment of the liver metastases by using illustrated examples in a case-based review. We will explore the CT, MR, PET-CT and intraoperative US imaging, including abbreviated MRI protocols, and also some brand new techniques that could allow a better management of the hepatic metastasis.

Conclusion

Optimal detection and characterization of liver metastases can alter patient management and the imaging methods play an fundamental role in this cenario.