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Preoperative Imaging of Liver Cancers: Metastases

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Venous Embolization of the Liver

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Abstract

Imaging plays a pivotal role in patients with suspected liver metastases not only for diagnosis but also for staging and for presurgical evaluation. Several modalities are available; these include ultrasound, CT, MRI, and PET or PET/CT. Ultrasound is operator-dependent and has generally low sensitivity for detection, especially for small lesions. CT is the most frequently used technique as it is quick, widely available, and accurate; however, it is limited by radiation exposure and has limited characterization of subcentimeter hepatic lesions. MRI is accurate and free of radiation exposure; however, it is limited by cost and availability. PET and PET/CT have a role mostly for detection of extrahepatic disease. The role and results of these modalities will be discussed in this review.

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References

  1. Baker ME, Pelley R. Hepatic metastases: basic principles and implications for radiologists. Radiology. 1995;197(2):329-337.

    PubMed  CAS  Google Scholar 

  2. Martinez L, Puig I, et al. Colorectal liver metastases: radiological diagnosis and staging. Eur J Surg Oncol. 2007;33(suppl 2):S5-S16.

    Article  PubMed  Google Scholar 

  3. Adams RB, Haller DG, et al. Improving resectability of hepatic colorectal metastases: expert consensus statement by Abdalla et al. Ann Surg Oncol. 2006;13(10):1281-1283.

    Article  PubMed  Google Scholar 

  4. Annemans L, Lencioni R, et al. Health economic evaluation of ferucarbotran-enhanced MRI in the diagnosis of liver metastases in colorectal cancer patients. Int J Colorectal Dis. 2008;23(1):77-83.

    Article  PubMed  Google Scholar 

  5. Charnsangavej C, Clary B, et al. Selection of patients for resection of hepatic colorectal metastases: expert consensus statement. Ann Surg Oncol. 2006;13(10):1261-1268.

    Article  PubMed  Google Scholar 

  6. Catalano OA, Singh AH, et al. Vascular and biliary variants in the liver: implications for liver surgery. Radiographics. 2008;28(2):359-378.

    Article  PubMed  Google Scholar 

  7. Jarnagin WR, Fong Y, et al. Liver resection for metastatic colorectal cancer: assessing the risk of occult irresectable disease. J Am Coll Surg. 1999;188(1):33-42.

    Article  PubMed  CAS  Google Scholar 

  8. Danet IM, Semelka RC, et al. Spectrum of MRI appearances of untreated metastases of the liver. AJR Am J Roentgenol. 2003;181(3):809-817.

    PubMed  Google Scholar 

  9. Semelka RC, Hussain SM, et al. Perilesional enhancement of hepatic metastases: correlation between MR imaging and histopathologic findings—initial observations. Radiology. 2000;215(1):89-94.

    PubMed  CAS  Google Scholar 

  10. Konopke R, Kersting S, et al. Contrast-enhanced ultrasonography to detect liver metastases: a prospective trial to compare transcutaneous unenhanced and contrast-enhanced ultrasonography in patients undergoing laparotomy. Int J Colorectal Dis. 2007;22(2):201-207.

    Article  PubMed  CAS  Google Scholar 

  11. Dietrich CF, Kratzer W, et al. Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI. World J Gastroenterol. 2006;12(11):1699-1705.

    PubMed  Google Scholar 

  12. Larsen LP, Rosenkilde M, et al. The value of contrast enhanced ultrasonography in detection of liver metastases from colorectal cancer: a prospective double-blinded study. Eur J Radiol. 2007;62(2):302-307.

    Article  PubMed  Google Scholar 

  13. Sugimoto K, Shiraishi J, et al. Improved detection of hepatic metastases with contrast-enhanced low mechanical-index pulse inversion ultrasonography during the liver-specific phase of sonazoid: observer performance study with JAFROC analysis. Acad Radiol. 2009;16(7):798-809.

    Article  PubMed  Google Scholar 

  14. Hatanaka K, Kudo M, et al. Sonazoid-enhanced ultrasonography for diagnosis of hepatic malignancies: comparison with contrast-enhanced CT. Oncology. 2008;75(suppl 1):42-47.

    Article  PubMed  Google Scholar 

  15. Moriyasu F, Itoh K. Efficacy of perflubutane microbubble-enhanced ultrasound in the characterization and detection of focal liver lesions: phase 3 multicenter clinical trial. AJR Am J Roentgenol. 2009;193(1):86-95.

    Article  PubMed  Google Scholar 

  16. Cervone A, Sardi A, et al. Intraoperative ultrasound (IOUS) is essential in the management of metastatic colorectal liver lesions. Am Surg. 2000;66(7):611-615.

    PubMed  CAS  Google Scholar 

  17. Foroutani A, Garland AM, et al. Laparoscopic ultrasound vs triphasic computed tomography for detecting liver tumors. Arch Surg. 2000;135(8):933-938.

    Article  PubMed  CAS  Google Scholar 

  18. Kruskal JB, Kane RA. Intraoperative US of the liver: techniques and clinical applications. Radiographics. 2006;26(4):1067-1084.

    Article  PubMed  Google Scholar 

  19. Scaife CL, Ng CS, et al. Accuracy of preoperative imaging of hepatic tumors with helical computed tomography. Ann Surg Oncol. 2006;13(4):542-546.

    Article  PubMed  Google Scholar 

  20. Ellsmere J, Kane R, et al. Intraoperative ultrasonography during planned liver resections: Why are we still performing it? Surg Endosc. 2007;21(8):1280-1283.

    Article  PubMed  Google Scholar 

  21. Sahani DV, Kalva SP, et al. Intraoperative US in patients undergoing surgery for liver neoplasms: comparison with MR imaging. Radiology. 2004;232(3):810-814.

    Article  PubMed  Google Scholar 

  22. Tamandl D, Herberger B, et al. Adequate preoperative staging rarely leads to a change of intraoperative strategy in patients undergoing surgery for colorectal cancer liver metastases. Surgery. 2008;143(5):648-657.

    Article  PubMed  Google Scholar 

  23. Choti MA, Kaloma F, et al. Patient variability in intraoperative ultrasonographic characteristics of colorectal liver metastases. Arch Surg. 2008;143(1):29-34; discussion 35.

    Article  PubMed  Google Scholar 

  24. Ong KO, Leen E. Radiological staging of colorectal liver metastases. Surg Oncol. 2007;16(1):7-14.

    Article  PubMed  Google Scholar 

  25. Kamel IR, Fishman EK. Recent advances in CT imaging of liver metastases. Cancer J. 2004;10(2):104-120.

    Article  PubMed  Google Scholar 

  26. Soyer P, Poccard M, et al. Detection of hypovascular hepatic metastases at triple-phase helical CT: sensitivity of phases and comparison with surgical and histopathologic findings. Radiology. 2004;231(2):413-420.

    Article  PubMed  Google Scholar 

  27. Bonaldi VM, Bret PM, et al. Helical CT of the liver: value of an early hepatic arterial phase. Radiology. 1995;197(2):357-363.

    PubMed  CAS  Google Scholar 

  28. Francis IR, Cohan RH, et al. Multidetector CT of the liver and hepatic neoplasms: effect of multiphasic imaging on tumor conspicuity and vascular enhancement. AJR Am J Roentgenol. 2003;180(5):1217-1224.

    PubMed  Google Scholar 

  29. Schwartz LH, Gandras EJ, et al. Prevalence and importance of small hepatic lesions found at CT in patients with cancer. Radiology. 1999;210(1):71-74.

    PubMed  CAS  Google Scholar 

  30. Khalil HI, Patterson SA, et al. Hepatic lesions deemed too small to characterize at CT: prevalence and importance in women with breast cancer. Radiology. 2005;235(3):872-878.

    Article  PubMed  Google Scholar 

  31. Erturk SM, Ichikawa T, et al. PET imaging for evaluation of metastatic colorectal cancer of the liver. Eur J Radiol. 2006;58(2):229-235.

    Article  PubMed  Google Scholar 

  32. Truant S, Huglo D, et al. Prospective evaluation of the impact of [18F] fluoro-2-deoxy-D-glucose positron emission tomography of resectable colorectal liver metastases. Br J Surg. 2005;92(3):362-369.

    Article  PubMed  CAS  Google Scholar 

  33. Chua SC, Groves AM, et al. The impact of 18F-FDG PET/CT in patients with liver metastases. Eur J Nucl Med Mol Imaging. 2007;34(12):1906-1914.

    Article  PubMed  Google Scholar 

  34. Badiee S, Franc BL, et al. Role of IV iodinated contrast material in 18F-FDG PET/CT of liver metastases. AJR Am J Roentgenol. 2008;191(5):1436-1439.

    Article  PubMed  Google Scholar 

  35. Dirisamer A, Halpern BS, et al. Dual-time-point FDG-PET/CT for the detection of hepatic metastases. Mol Imaging Biol. 2008;10(6):335-340.

    Article  PubMed  Google Scholar 

  36. Bruegel M, Gaa J, et al. Diagnosis of hepatic metastasis: comparison of respiration-triggered diffusion-weighted echo-planar MRI and five t2-weighted turbo spin-echo sequences. AJR Am J Roentgenol. 2008;191(5):1421-1429.

    Article  PubMed  Google Scholar 

  37. Parikh T, Drew SJ, et al. Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology. 2008;246(3):812-822.

    Article  PubMed  Google Scholar 

  38. Gandhi SN, Brown MA, et al. MR contrast agents for liver imaging: what, when, how. Radiographics. 2006;26(6):1621-1636.

    Article  PubMed  Google Scholar 

  39. Kim YK, Lee JM, et al. Detection of liver metastases: gadobenate dimeglumine-enhanced three-dimensional dynamic phases and one-hour delayed phase MR imaging versus superparamagnetic iron oxide-enhanced MR imaging. Eur Radiol. 2005;15(2):220-228.

    Article  PubMed  Google Scholar 

  40. Hammerstingl R, Huppertz A, et al. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol. 2008;18(3):457-467.

    Article  PubMed  Google Scholar 

  41. Reimer P, Balzer T. Ferucarbotran (Resovist): a new clinically approved RES-specific contrast agent for contrast-enhanced MRI of the liver: properties, clinical development, and applications. Eur Radiol. 2003;13(6):1266-1276.

    PubMed  Google Scholar 

  42. Ward J, Robinson PJ, et al. Liver metastases in candidates for hepatic resection: comparison of helical CT and gadolinium- and SPIO-enhanced MR imaging. Radiology. 2005;237(1):170-180.

    Article  PubMed  Google Scholar 

  43. Kim HJ, Kim KW, et al. Comparison of mangafodipir trisodium- and ferucarbotran-enhanced MRI for detection and characterization of hepatic metastases in colorectal cancer patients. AJR Am J Roentgenol. 2006;186(4):1059-1066.

    Article  PubMed  Google Scholar 

  44. Mueller GC, Hussain HK, et al. Effectiveness of MR imaging in characterizing small hepatic lesions: routine versus expert interpretation. AJR Am J Roentgenol. 2003;180(3):673-680.

    PubMed  Google Scholar 

  45. Weinreb JC. Which study when? Is gadolinium-enhanced MR imaging safer than iodine-enhanced CT? Radiology. 2008;249(1):3-8.

    Article  PubMed  Google Scholar 

  46. Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. AJR Am J Roentgenol. 2004;183(6):1673-1689.

    PubMed  Google Scholar 

  47. Kanal E, Barkovich AJ, et al. ACR guidance document for safe MR practices: 2007. AJR Am J Roentgenol. 2007;188(6):1447-1474.

    Article  PubMed  Google Scholar 

  48. Thomsen HS, Marckmann P, et al. Update on nephrogenic systemic fibrosis. Magn Reson Imaging Clin N Am. 2008;16(4):551-560.

    Article  PubMed  Google Scholar 

  49. Bipat S, van Leeuwen MS, et al. Colorectal liver metastases: CT, MR imaging, and PET for diagnosis–meta-analysis. Radiology. 2005;237(1):123-131.

    Article  PubMed  Google Scholar 

  50. Cantwell CP, Setty BN, et al. Liver lesion detection and characterization in patients with colorectal cancer: a comparison of low radiation dose non-enhanced PET/CT, contrast-enhanced PET/CT, and liver MRI. J Comput Assist Tomogr. 2008;32(5):738-744.

    Article  PubMed  Google Scholar 

  51. Coenegrachts K, De Geeter F, et al. Comparison of MRI (including SS SE-EPI and SPIO-enhanced MRI) and FDG-PET/CT for the detection of colorectal liver metastases. Eur Radiol. 2008;16:16.

    Google Scholar 

  52. Wiering B, Ruers TJ, et al. Comparison of multiphase CT, FDG-PET and intra-operative ultrasound in patients with colorectal liver metastases selected for surgery. Ann Surg Oncol. 2007;14(2):818-826.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Richard K. G. Do M.D., Ph.D.

  2. Department of Radiology, Mount Sinai Medical Center, New York, NY, USA

    Bachir Taouli

Authors
  1. Richard K. G. Do M.D., Ph.D.
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  2. Bachir Taouli
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Correspondence to Bachir Taouli .

Editor information

Editors and Affiliations

  1. New York-Presbyterian Hospital, New York, 10032, New York, USA

    David C. Madoff

  2. University of Tokyo, Hongo 7-3-1, Tokyo, 113-8656, Japan

    Masatoshi Makuuchi

  3. School of Medicine, Dept. Surgery I, Nagoya University, Tsurumai-cho 65, Nagoya, Aichi-ken, 466-8550, Japan

    Masato Nagino

  4. M.D. Anderson Cancer Center, Dept. Surgical Oncology, University of Texas, Holcombe Blvd. 1515, Houston, 77030, Texas, USA

    Jean-Nicolas Vauthey

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© 2011 Springer-Verlag London Limited

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Do, R.K.G., Taouli, B. (2011). Preoperative Imaging of Liver Cancers: Metastases. In: Madoff, D., Makuuchi, M., Nagino, M., Vauthey, JN. (eds) Venous Embolization of the Liver. Springer, London. https://doi.org/10.1007/978-1-84882-122-4_9

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  • DOI: https://doi.org/10.1007/978-1-84882-122-4_9

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  • Print ISBN: 978-1-84882-121-7

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