Liver metastases

Abstract

Liver metastases are the most common malignant hepatic lesions. Their accurate and early detection is crucial to select the most appropriate therapeutic strategy. Advances in the treatment of metastatic liver disease have been shown to improve significantly the survival of affected patients. Radiological diagnostic modalities play a major role in the workup and selection of appropriate treatment planning. An exact knowledge of lesion number, size, and distribution within the liver parenchyma, as well as volumetric and functional information about residual liver parenchyma, are essential for the optimal selection of patients who will benefit from individually planned resection. The detection of small focal liver lesions, in particular, remains a diagnostic challenge. The development of new imaging modalities, functional imaging, the availability of novel contrast agents, and the discussion about alternative tumor response criteria have further improved the radiological role in lesion detection, characterization, and assessment of treatment response. In addition to the typical imaging pattern of hepatic metastases, unusual radiological findings, uncommon response patterns, complications, and therapeutic toxicities should be known by radiologists to guide proper patient management.