Clinical Implications of Liver Malignancies
A variety of imaging techniques can be used to identify liver lesions each one with their own sensitivity, specificity, and spatial resolution. Ultrasonography (US) remains the most readily available mode; its diagnostic potential within the context of liver neoplasms could further be enhanced with the addition of contrast administration (contrast-enhanced US (CEUS)). Computed tomography (CT) and magnetic resonance imaging (MRI) of the liver has been recognized as more reliable and reproducible techniques because of their dynamic and multiphasic imaging capacity. Contrast-enhanced multidetector CT (MDCT) and MRI are used for diagnostic purposes as well as to assess the tumor burden, vascular or biliary invasion, future liver remnant volume; finally, CT and/or MRI could give information for structural features of preexisting chronic liver disease (i.e., features of portal hypertension, liver contour, etc.). Other modalities, such as CT arterioportography (CTAP), CT hepatic arteriography (CTHA), and laparoscopy with or without intraoperative US, are also used depending on experience of the clinicians and radiologists. Finally, positron emission tomography with either 18-fluorodeoxyglucose (18-FDG-PET) or choline has also added a new dimension to functional liver imaging.
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