Imaging Features of Hepatic Metastases: CT and MR

  • Christiane Kulinna
  • Wolfgang Schima
Part of the Medical Radiology book series (MEDRAD)


Liver Metastasis Hepatic Metastasis Arterial Phase Magn Reson Image Focal Nodular Hyperplasia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Aicher KP, Laniado M, Kopp AF, et al (1993) Mn-DPDP-enhanced MR imaging of malignant liver lesions: efficacy and safety in 20 patients. J Magn Reson Imaging 3:731–737PubMedGoogle Scholar
  2. August DA, Ottow RT, Sugarbaker PH (1984) Clinical perspective of human colorectal cancer metastasis. Cancer Metastasis Rev 3:303–324PubMedGoogle Scholar
  3. Awai K, Takada K, Onishi H, et al (2002) Aortic and hepatic enhancement and tumor-to-liver contrast: analysis of the effect of different concentrations of contrast material at multi-detector row helical CT. Radiology 224:757–763PubMedGoogle Scholar
  4. Bader TR, Grabenwoger F, Prokesch RW, et al (2000) Measurement of hepatic perfusion with dynamic computed tomography: assessment of normal values and comparison of two methods to compensate for motion artifacts. Invest Radiol 35:539–547PubMedGoogle Scholar
  5. Bartolozzi C, Lencioni R, Donati F, et al (2000) Abdominal MR: liver and pancreas. Categorial Course Eur Radiol 10:121–137Google Scholar
  6. Bartolozzi C, Cioni D, Donati F, et al (2001) Focal liver lesions: MR imaging-pathologic correlation. Eur Radiol 11:1374–1388CrossRefPubMedGoogle Scholar
  7. Bernardino ME, Young SW, Lee JK, et al (1992) Hepatic MR imaging with Mn-DPDP: safety, image quality, and sensitivity. Radiology 183:53–38PubMedGoogle Scholar
  8. Bismuth H, Chiche L, Castaing D (1995) Surgical treatment of hepatocellular carcinomas in noncirrhotic liver: experience with 68 liver resections. World J Surg 19:35–41PubMedGoogle Scholar
  9. Bradley AL, Chapman WC, Wright JK (1999) Surgical experience with hepatic colorectal metastases. Am J Surg 65:560–566Google Scholar
  10. Chen WP, Chen JH, Hwang JI (1999) Spectrum of transient hepatic attenuation differences in biphasic CT. AJR Am J Roentgenol 172:419–424PubMedGoogle Scholar
  11. Dixon WT (1984) Single proton spectroscopic imaging. Radiology 153:189–194PubMedGoogle Scholar
  12. Doci R, Gennari L, Bignami P, et al (1991) One hundred patients with hepatic metastases from colorectal cancer treated by resection: analysis of prognostic determinants. Br J Surg 78:797–801PubMedGoogle Scholar
  13. Engeroff B, Kopka L, Harz C, et al (2001) Impact of different iodine concentrations on abdominal enhancement in biphasic multislice helical CT. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:938–941CrossRefPubMedGoogle Scholar
  14. Ernst O, Sergent G, Mizrahi D, et al (1999) Treatment of hepatocellular carcinoma by transcatheter arterial chemoembolization: comparison of planned periodic chemoembolization and chemoembolization based on tumor response. AJR Am J Roentgenol 172:59–64PubMedGoogle Scholar
  15. Foley WD, Mallisee TA, Hohenwalter MD, et al (2000) Multiphase hepatic CT with a multirow detector CT scanner. AJR Am J Roentgenol 175:679–685PubMedGoogle Scholar
  16. Fong Y, Sun RL, Jarnagin W, et al (1999) An analysis of 412 cases of hepatocellular carcinoma at a western center. Ann Surg 229:790–799CrossRefPubMedGoogle Scholar
  17. Frederick MG, Paulson EK, Nelson RC (1997) Helical CT for detection focal liver lesions in patients with breast carcinoma: comparison of noncontrast phase, hepatic arterial phase and portal venous phase. J Comput Assist Tomogr 21:229–235CrossRefPubMedGoogle Scholar
  18. Funke M, Kopka L, Grabbe E (2001) Biphasic contrast-enhanced multislice helical CT of the liver. In: Reiser MF, Takahashi M, Modic M, Bruening R (eds) Multislice CT. Springer-Verlag, Berlin Heidelberg New York, pp 35–38Google Scholar
  19. Goldberg A, Hahn PF, Saini S, et al (1993) Value of T1 and T2 relaxation times from echoplanar imaging in the characterization of focal hepatic lesions. AJR Am J Roentgenol 160:1011–1017PubMedGoogle Scholar
  20. Guo WJ, Yu EX, Liu LM, et al (2003) Comparison between chemoembolization combined with radiotherapy and chemoembolization alone for large hepatocellular carcinoma. World J Gastroenterol 9:1697–1701PubMedGoogle Scholar
  21. Hahn PF, Saini S (1998) Liver-specific MR imaging contrast agents. Radiol Clin North Am 36:287–297CrossRefPubMedGoogle Scholar
  22. Haider MA, Amitai MM, Rappaport DC, et al (2002) Multi-detector row helical CT in preoperative assessment of small (< or =1.5 cm) liver metastases: is thinner collimation better? Radiology 222:137–142Google Scholar
  23. Hamm B, Vogl TJ, Branding G (1992) Focal liver lesions: MR imaging with Mn-DPDP — initial clinical results in 40 patients. Radiology 182:167–174PubMedGoogle Scholar
  24. Harisinghani MG, Jhaveri KS, Weissleder R, et al (2001) MRI contrast agents for evaluating focal hepatic lesions. Clin Radiol 56:714–725CrossRefPubMedGoogle Scholar
  25. Herts BR, Einstein DM, Paushter DM (1993) Spiral CT of the abdomen: artefacts and potential pitfalls. AJR Am J Roentgenol 161:1185–1190PubMedGoogle Scholar
  26. Ichikawa T, Kitamura T, Nakajima H, et al (2002) Hypervascular hepatocellular carcinoma: can double arterial phase imaging with multidetector CT improve tumor depiction in the cirrhotic liver? AJR Am J Roentgenol 179:751–758PubMedGoogle Scholar
  27. Itai Y, Saida Y (2002) Pitfalls in liver imaging. Eur Radiol 12:1162–1174CrossRefPubMedGoogle Scholar
  28. Ito K, Mitchell DG, Outwater EK, et al (1997) Hepatic lesions: discrimination of nonsolid, benign lesions from solid malignant lesions with heavily T2-weighted fast spinecho MR imaging. Radiology 204:729–737PubMedGoogle Scholar
  29. Jang HJ, Lim HK, Lee WJ, et al (2002) Small Hypoattenuating lesions in the liver on single-phase helical CT in preoperative patients with gastric and colorectal cancer: prevalence, significance, and differentiating features. J Comput Assist Tomogr 26:718–724CrossRefPubMedGoogle Scholar
  30. Jones EC, Chezmar JL, Nelson RC, et al (1992) The frequency and significance of small (less than or equal to 15 mm) hepatic lesions detected by CT. AJR Am J Roentgenol 158:535–539PubMedGoogle Scholar
  31. Kelekis NL, Semelka RC, Woosley JT (1996) Malignant lesions of the liver with high signal intensity on T1-weighted MR images. J Magn Reson Imaging 6:291–294PubMedGoogle Scholar
  32. Kim T, Murakami T, Takahashi S, et al (1998a) Effects of injection rates of contrast material on arterial phase hepatic CT. AJR Am J Roentgenol 171:429–432PubMedGoogle Scholar
  33. Kim TK, Choi BI, Han JK, et al (1998b) Nontumorous arterioportal shunt mimicking hypervascular tumor in cirrhotic liver: two-phase spiral CT findings. Radiology 208:597–603PubMedGoogle Scholar
  34. Kinkel K, Lu Y, Both M, et al (2002) Detection of hepatic metastases from cancers of the gastrointestinal tract by using non-invasive imaging methods (US, CT, MR imaging, PET): a meta-analysis. Radiology 224:748–756PubMedGoogle Scholar
  35. Kokubo T, Itai Y, Ohtomo K (1988) Muci-hypersecreting intrahepatic biliary neoplasms. Radiology 168:609–614PubMedGoogle Scholar
  36. Kopka L, Funke M, Fischer U, et al (1995) Parenchymal liver enhancement with bolus-triggered helical CT: preliminary clinical results. Radiology 195:282–284PubMedGoogle Scholar
  37. Kopka L, Rodenwaldt J, Fischer U, et al (1996) Dual-phase helical CT of the liver: effects of bolus tracking and different volumes of contrast material. Radiology 201:321–326PubMedGoogle Scholar
  38. Kopka L, Rodenwaldt J, Hamm BK (2000) Value of hepatic perfusion imaging for indirect detection of different liver lesions: feasibility study with multi-slice helical CT. Radiology 217(P):457Google Scholar
  39. Kulinna C, Helmberger T, Kessler M, et al (2001) Improvement in diagnosis of liver metastases with the multi-detector CT. Radiologe 41:16–23CrossRefPubMedGoogle Scholar
  40. Llado L, Virgili J, Figueras J, et al (2000) A prognostic index of the survival of patients with unresectable hepatocellular carcinoma after transcatheter arterial chemoembolization. Cancer 88:50–57Google Scholar
  41. Loyer EM, Chin H, DuBrow RA, et al (1999) Hepatocellular carcinoma and intrahepatic peripheral cholangiocarcinoma: enhancement patterns with quadruple phase helical CT. A comparative study. Radiology 212:866–875PubMedGoogle Scholar
  42. Mahfouz AE, Hamm B, Mathieu D (1996) Imaging of metastases to the liver. Eur Radiol 6:607–614CrossRefPubMedGoogle Scholar
  43. Mann GN, Marx HF, Lai LL, et al (2001) Clinical and cost effectiveness of a new hepatocellular MRI contrast agent, mangafodipir trisodium, in the preoperative assessment of liver respectability. Ann Surg Oncol 8:573–579PubMedGoogle Scholar
  44. Miller FH, Butler RS, Hoff FL, et al (1998) Using triphasic helical CT to detect focal hepatic lesions in patients with neoplasms. AJR Am J Roentgenol 171:643–649PubMedGoogle Scholar
  45. Mueller GC, Hussain HK, Carlos RC, et al (2003) Effectiveness of MR imaging in characterizing small hepatic lesions: routine versus expert interpretation. AJR Am J Roentgenol 180:673–680PubMedGoogle Scholar
  46. Nelson RC, Chezmar JL, Sugarbaker PH, et al (1990) Preoperative localization of focal liver lesions to specific liver segments: utility of CT during arterial portography. Radiology 176:89–94PubMedGoogle Scholar
  47. Nordlinger B, Guiguet M, Vaillant JC (1996) Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Cancer 77:1254–1262CrossRefPubMedGoogle Scholar
  48. Ohnesorge B, Flohr T, Schaller S, et al (1999) The technical bases and uses of multi-slice CT. Radiologe 39:923–931CrossRefPubMedGoogle Scholar
  49. Oliver JH 3rd, Baron RL, Federle MP, et al (1997) Hypervascular liver metastases: do unenhanced and hepatic arterial phase CT images affect tumor detection? Radiology 205:709–715PubMedGoogle Scholar
  50. Oliver JH 3rd, Baron RL, Federle MP (1998) Hypervascular liver metastases: do unenhanced and hepatic arterial phase CT images affect tumor detection? Radiology 209:585–586Google Scholar
  51. Padovani B, Lecesne R, Raffaelli C, et al (1995) Phase III study of MN-DPDP in MR imaging and contrast-enhanced CT. Radiology 197(P):415Google Scholar
  52. Patten RM, Byun JY, Freeny PC (1993) CT of hypervascular hepatic tumors: are unenhanced scans necessary for diagnosis ? AJR Am J Roentgenol 161:979–984PubMedGoogle Scholar
  53. Paulson EK, McDermott VG, Keogan MT, et al (1998) Carcinoid metastases to the liver: role of triple-phase helical CT. Radiology 206:143–150PubMedGoogle Scholar
  54. Poeckler-Schoeniger C, Koepke J, Gueckel F, et al (1999) MRI with supermagnetic iron oxide: efficacy in the detection and characterization of focal hepatic lesions. Magn Reson Imaging 17:383–392PubMedGoogle Scholar
  55. Pickren JK, Tsukada Y, Lane WW (1982) Liver metastasis. Analysis of autopsy data. In: Weiss L, Gilbert HA (eds) Liver metastasis. Hall, Boston, pp 2–18Google Scholar
  56. Reimer P, Tombach B (1998) Hepatic MRI with SPIO: detection and characterization of focal liver lesions. Eur Radiol 8:1198–1204PubMedGoogle Scholar
  57. Rose AT, Rose DM, Pinson CW, et al (1998) Hepatocellular carcinoma outcomes based on indicate treatment strategy. Am J Surg 64:1128–1134Google Scholar
  58. Rummeny EJ, Wernecke K, Saini S, et al (1992) Comparison between high-field strength MR imaging and CT for screening of hepatic metastases: a receiver operating characteristic analysis. Radiology 182:879–886PubMedGoogle Scholar
  59. Rummeny EJ, Torres CG, Kurdziel JC, et al (1997) Mn-DPDP for MR imaging of the liver. Results of an independent image evaluation of the European phase III studies. Acta Radiol 38:638–642PubMedGoogle Scholar
  60. Scheele J, Stang R, Altendorf-Hofmann A, et al (1995) Resection of colorectal liver metastases. World J Surg 19:59–71CrossRefPubMedGoogle Scholar
  61. Schertz LD, Lee JK, Heiken JP, et al (1989) Proton spectroscopic imaging (Dixon method) of the liver: clinical utility. Radiology 173:401–405PubMedGoogle Scholar
  62. Schima W, Saini S, Echeverri JA, et al (1997) Focal liver lesions: characterization with conventional spin-echo versus fast spin-echo T2-weighted MR imaging. Radiology 202:389–393PubMedGoogle Scholar
  63. Schwartz LH, Gandras EJ, Colangelo SM, et al (1999) Prevalence and importance of small hepatic lesions found at CT in patients with cancer. Radiology 210:71–74PubMedGoogle Scholar
  64. Semelka RC, Helmberger TK (2001) Contrast agents for MR imaging of the liver. Radiology 218:327–332Google Scholar
  65. Semelka RC, Shoenut JP, Kroeker MA (1992) Focal liver disease: comparison of dynamic contrast-enhanced CT and T2-weighted fat-suppressed, FLASH, and dynamic gadolinium-enhanced MR imaging at 1.5T. Radiology 184:687–694PubMedGoogle Scholar
  66. Semelka RC, Worawattanakul S, Kelekis NL (1997) Liver lesion detection, characterization and effect on patient management: comparison of single-phase spiral CT and current MR techniques. J Magn Reson Imaging 7:1040–1047PubMedGoogle Scholar
  67. Sheafor DH, Frederick MG, Paulson EK (1999) Comparison of unenhanced, hepatic arterial-dominant and portal venous-dominant phase helical CT for the detection of liver metastases in women with breast carcinoma. AJR Am J Roentgenol 172:961–968PubMedGoogle Scholar
  68. Sica GT, Hoon J, Pablo RR (2000) CT and MR imaging of hepatic metastases. AJR Am J Roentgenol 174:691–698PubMedGoogle Scholar
  69. Silverman PM, Brown B, Wray H, et al (1995a) Optimal contrast enhancement of the liver using helical (spiral) CT: value of SmartPrep. AJR Am J Roentgenol 164:1169–1171PubMedGoogle Scholar
  70. Silverman PM, Cooper CJ, Weltman DI, et al (1995b) Helical CT: practical considerations and potential pitfalls. Radiographics 15:25–36PubMedGoogle Scholar
  71. Simon GH, Daldrup-Link HE, Rummeny EJ (2003) MR imaging of hepatic metastases. Imaging Decisions 1:19–28Google Scholar
  72. Slater GJ, Saini S, Mayo-Smith WW, et al (1996) Mn-DPDP enhanced MR imaging of the liver: analysis of pulse sequence performance. Clin Radiol 51:484–486CrossRefPubMedGoogle Scholar
  73. Sugarbaker PH (1993) Metastatic inefficiency: the scientifi c basis for resection of liver metastases from colorectal cancer. J Surg Oncol Suppl 3:158–160PubMedGoogle Scholar
  74. Sun HC, Tang ZY (2003) Preventive treatments for recurrence after curative resection of hepatocellular carcinoma. A literature review of randomized control trials. World J Gastroenterol 9:635–640PubMedGoogle Scholar
  75. Tublin ME, Tessler FN, Cheng SL, et al (1999) Effect of injection rate of contrast medium on pancreatic and hepatic helical CT. Radiology 210:97–101PubMedGoogle Scholar
  76. Valls C, Andia E, Sanchez A (2001) Hepatic metastases from colorectal cancer: preoperative detection and assessment of respectability with helical CT. Radiology 218:55–60PubMedGoogle Scholar
  77. van Etten B, Van der Sijp JRM, Kruyt RH, et al (2002) Ferumoxide-enhanced magnetic resonance imaging techniques in preoperative assessment for colorectal liver metastases. Eur J Surg Oncol 28:645–651PubMedGoogle Scholar
  78. van Leeuwen MS, Noordzij J, Feldberg MA, et al (1996) Focal liver lesions: characterization with triphasic spiral CT. Radiology 201:327–336PubMedGoogle Scholar
  79. van Ooijen B, Wiggers T (1992) Hepatic resections for colorectal metastases in the Netherlands. A multi-institutional study. Cancer 70:28–34PubMedGoogle Scholar
  80. Vogl TJ, Hammerstingl, R, Schwarz W (1996a) Supermagnetic iron oxide-enhanced versus gadolinium-enhanced MR imaging for differential diagnosis for focal liver lesions. Radiology 198:881–887PubMedGoogle Scholar
  81. Vogl TJ, Kummel S, Hammerstingl R (1996b) Liver tumors: comparison of MR imaging with Gd-EOB-DTPA and Gd-DTPA. Radiology 200:59–67PubMedGoogle Scholar
  82. Wang C, Ahlström H, Eriksson B, et al (1998) Uptake of man-gafodipir trisodium in liver metastases from endocrine tumors. J Magn Reson Imaging 8:682–686PubMedGoogle Scholar
  83. Ward J, Naik KS, Guthrie JA, et al (1999) Hepatic lesion detection: comparison of MR imaging after the administration of supermagnetic iron oxide with dual phase CT by using alternative free response receiver operating characteristic analysis. Radiology 210:459–466PubMedGoogle Scholar
  84. Weg N, Scheer MR, Gabor MP (1998) Liver lesions: improved detection with dual-detector-array CT and routine 2.5 mm thin collimation. Radiology 209:417–426PubMedGoogle Scholar
  85. Wittenberg J, Stark DD, Forman BH, et al (1988) Differentiation of hepatic metastases from hepatic hemangiomas and cysts by using MR imaging. AJR Am J Roentgenol 151:79–84PubMedGoogle Scholar
  86. Wood CB, Gillis CR, Blumgart LH (1976) A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Oncol 2:285–288PubMedGoogle Scholar
  87. Yamasaki T, Kurokawa F, Shirahashi H, et al (2002) Percutaneous radiofrequency ablation therapy for patients with hepatocellular carcinoma during occlusion of hepatic blood flow. Comparison with standard percutaneous radiofrequency ablation therapy. Cancer 95:2353–2360CrossRefPubMedGoogle Scholar
  88. Yamashita Y, Matsukawa T, Arakawa A, et al (1995) US-guided liver biopsy: predicting the effect of interventional treatment of hepatocellular carcinoma. Radiology 196:799–804PubMedGoogle Scholar
  89. Yoon SS, Charny CK, Fong Y, et al (2003) Diagnosis, management, and outcomes of 115 patients with hepatic hemangioma. J Am Coll Surg 197:392–402CrossRefPubMedGoogle Scholar
  90. Zacherl J, Scheuba C, Imhof M, et al (2002) Current value of intraoperative sonography during surgery for hepatic neoplasms. World J Surg 26:550–554CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2005

Authors and Affiliations

  • Christiane Kulinna
    • 1
  • Wolfgang Schima
    • 1
  1. 1.Department of RadiologyMedical University of ViennaViennaAustria

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