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Open AccessReview

Imaging of Colorectal Liver Metastases: New Developments and Pending Issues

1
Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, 40138 Bologna, Italy
2
Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
3
Diagnostic and Interventional Radiology, ASST Santi Paolo e Carlo, San Paolo Hospital, 20142 Milan, Italy
4
Department of Specialised, Experimental and Diagnostic Medicine, Sant’Orsola Hospital, University of Bologna, 40138 Bologna, Italy
5
Unit of Radiology, IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(1), 151; https://doi.org/10.3390/cancers12010151
Received: 17 November 2019 / Revised: 31 December 2019 / Accepted: 6 January 2020 / Published: 8 January 2020
(This article belongs to the Special Issue Liver Cancer and Potential Therapeutic Targets)
Computed tomography (CT), magnetic resonance imaging (MRI), and 18-fluorideoxyglucose positron emission tomography (18FDG-PET) are historically the most accurate imaging techniques for diagnosing liver metastases. Recently, the combination of diffusion-weighted imaging and hepatospecific contrast media, such as gadoxetic acid in MRI, have been demonstrated to have the highest diagnostic accuracy, sensitivity, and specificity for detecting liver metastases. Various recent meta-analyses have confirmed the diagnostic superiority of this combination (diffusion-weighted imaging and gadoxetic acid-enhanced MRI), especially in terms of per lesion sensitivity, as compared with CT and 18FDG-PET, even for smaller lesions (≤1 cm). However, none of the oncological guidelines have suggested the use of MRI as a first-line technique for liver metastasis detection during the staging process of oncological patients. This review analyzes the history of the principal imaging techniques for the diagnosis of liver metastases, in particular of colorectal liver metastases, focusing on the most accurate method (diffusion-weighted imaging combined with gadoxetic acid-enhanced MRI), possible reasons for the lack of its diffusion in the guidelines, and possible future scenarios. View Full-Text
Keywords: metastasis; liver imaging; magnetic resonance imaging; diffusion-weighted imaging; hepatobiliary contrast agent metastasis; liver imaging; magnetic resonance imaging; diffusion-weighted imaging; hepatobiliary contrast agent
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Renzulli, M.; Clemente, A.; Ierardi, A.M.; Pettinari, I.; Tovoli, F.; Brocchi, S.; Peta, G.; Cappabianca, S.; Carrafiello, G.; Golfieri, R. Imaging of Colorectal Liver Metastases: New Developments and Pending Issues. Cancers 2020, 12, 151.

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