G H Pöhler1, K I Ringe2. 1. Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Hannover, Deutschland. 2. Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Hannover, Deutschland. ringe.kristina@mh-hannover.de.
Abstract
CLINICAL PROBLEM: Colorectal metastases are the most common malignant liver lesions. Imaging of the liver in patients with colorectal carcinoma is performed for early detection of liver metastases (CRLM) at the time of initial tumor diagnosis, for monitoring and follow-up in order to exclude or diagnose metachronous metastases. STANDARD RADIOLOGICAL METHODS: Radiological imaging includes primarily multislice computed tomography (CT) and magnetic resonance imaging (MRI), which play an important role regarding therapeutic management and assessment of prognosis. PERFORMANCE, ACHIEVEMENTS: Contrast-enhanced CT is broadly available and allows for rapid image acquisition including the possibility for complete tumor staging. MRI, on the other hand, is characterized by very good soft tissue contrast and has-especially with the use of diffusion-weighted imaging and administration of liver-specific contrast agents-the highest sensitivity for detection of metastases smaller than 1 cm. PRACTICAL RECOMMENDATIONS: The choice of imaging in daily routine is often dependent on availability and clinical question. Frequently, e.g. for assessment of resectability (extent of metastases, anatomic relation of lesions to critical structures), both modalities may be implemented in combination.
CLINICAL PROBLEM: Colorectal metastases are the most common malignant liver lesions. Imaging of the liver in patients with colorectal carcinoma is performed for early detection of liver metastases (CRLM) at the time of initial tumor diagnosis, for monitoring and follow-up in order to exclude or diagnose metachronous metastases. STANDARD RADIOLOGICAL METHODS: Radiological imaging includes primarily multislice computed tomography (CT) and magnetic resonance imaging (MRI), which play an important role regarding therapeutic management and assessment of prognosis. PERFORMANCE, ACHIEVEMENTS: Contrast-enhanced CT is broadly available and allows for rapid image acquisition including the possibility for complete tumor staging. MRI, on the other hand, is characterized by very good soft tissue contrast and has-especially with the use of diffusion-weighted imaging and administration of liver-specific contrast agents-the highest sensitivity for detection of metastases smaller than 1 cm. PRACTICAL RECOMMENDATIONS: The choice of imaging in daily routine is often dependent on availability and clinical question. Frequently, e.g. for assessment of resectability (extent of metastases, anatomic relation of lesions to critical structures), both modalities may be implemented in combination.
Authors: E A Eisenhauer; P Therasse; J Bogaerts; L H Schwartz; D Sargent; R Ford; J Dancey; S Arbuck; S Gwyther; M Mooney; L Rubinstein; L Shankar; L Dodd; R Kaplan; D Lacombe; J Verweij Journal: Eur J Cancer Date: 2009-01 Impact factor: 9.162
Authors: Charlotte S van Kessel; Constantinus F M Buckens; Maurice A A J van den Bosch; Maarten S van Leeuwen; Richard van Hillegersberg; Helena M Verkooijen Journal: Ann Surg Oncol Date: 2012-03-07 Impact factor: 5.344