Imaging of colorectal liver metastases: New developments and pending issues

Matteo Renzulli, Alfredo Clemente, Anna Maria Ierardi, Irene Pettinari, Francesco Tovoli, Stefano Brocchi, Giuliano Peta, Salvatore Cappabianca, Gianpaolo Carrafiello, Rita Golfieri

Research output: Contribution to journalReview articlepeer-review


Computed tomography (CT), magnetic resonance imaging (MRI), and 18-fluorideoxyglucose positron emission tomography (18 FDG-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 and18 FDG-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.

Original languageEnglish
Article number151
Issue number1
Publication statusPublished - Jan 1 2020


  • Diffusion-weighted imaging
  • Hepatobiliary contrast agent
  • Liver imaging
  • Magnetic resonance imaging
  • Metastasis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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