TY - JOUR
T1 - Imaging of colorectal liver metastases
T2 - New developments and pending issues
AU - Renzulli, Matteo
AU - Clemente, Alfredo
AU - Ierardi, Anna Maria
AU - Pettinari, Irene
AU - Tovoli, Francesco
AU - Brocchi, Stefano
AU - Peta, Giuliano
AU - Cappabianca, Salvatore
AU - Carrafiello, Gianpaolo
AU - Golfieri, Rita
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - Diffusion-weighted imaging
KW - Hepatobiliary contrast agent
KW - Liver imaging
KW - Magnetic resonance imaging
KW - Metastasis
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U2 - 10.3390/cancers12010151
DO - 10.3390/cancers12010151
M3 - Review article
AN - SCOPUS:85077898932
VL - 12
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 1
M1 - 151
ER -