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Liver Imaging for Colorectal Cancer Metastases

  • Diagnostic and Interventional Radiology Innovations in Colorectal Cancer (G de Prisco, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Purpose of Review

The prognosis of colorectal carcinoma with liver metastases (CRLM) is driven largely by the resectability of hepatic metastatic disease. An increasing number of systemic and hepatic-directed therapies are being applied in the neoadjuvant setting to downstage patients for surgical eligibility. The goal of this review is to describe the use of imaging techniques in the management of CRLM with an emphasis on staging, pretreatment planning, and response assessment.

Recent Findings

While CT has an established role in screening for hepatic metastatic disease, MRI with hepatobiliary contrast has emerged as the workhorse technique in patients with CRLM in whom surgical intervention is being considered. Multiphasic CT and/or contrast-enhanced ultrasound are useful adjunctive tools, particularly when MRI is contraindicated. PET/CT provides added value in candidates for surgical resection or hepatic-directed therapy, primarily in its ability to exclude extra-hepatic metastatic disease.

Summary

Accurate staging and detailed presurgical anatomic assessment including volumetry, guide management in patients with CRLM, particularly in selecting for resection and hepatic-directed therapies.

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Authors and Affiliations

  1. Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Box 8131, St. Louis, MO, 63108, USA

    Daniel R. Ludwig, Aaron J. Mintz, Vanessa R. Sanders & Kathryn J. Fowler

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  1. Daniel R. Ludwig
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  2. Aaron J. Mintz
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Correspondence to Kathryn J. Fowler.

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Conflict of Interest

Daniel R. Ludwig declares that he has no conflict of interest.

Aaron J. Mintz declares that he has no conflict of interest.

Vanessa R. Sanders declares that she has no conflict of interest.

Kathryn J. Fowler has received compensation from Bayer for service as a consultant.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Diagnostic and Interventional Radiology Innovations in Colorectal Cancer

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Ludwig, D.R., Mintz, A.J., Sanders, V.R. et al. Liver Imaging for Colorectal Cancer Metastases. Curr Colorectal Cancer Rep 13, 470–480 (2017). https://doi.org/10.1007/s11888-017-0391-4

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