Detection and Characterization ofHepatic Metastases using Computed Tomography and Magnetic Resonance Imaging

Abstract

The liver provides a fertile soil for metastases, not only due to its dual blood supply from both systemic and portal systems, but also because of humoral factors promoting cell growth, and the discontinuous nature of the endothelial lining of the hepatic sinusoids. The liver is second only to regional lymph nodes as site of metastatic disease.

Most hepatic metastases arise from primary tumors in the colon, stomach, pancreas, breast and lung. Peripheral sarcomas, melanoma, renal and thyroid metastases and pelvic tumors are less common causes of hepatic metastases.

In pediatric patients the most common cause of the liver metastases is neuroblastoma, Wilm's tumor and rhabdomysarcoma.

A silent primary with hepatic metastases most often occurs in carcinoma of the pancreas, stomach and lung.

The advances in the medical and surgical treatment of hepatic metastases confronted the radiologists with the need to accurately detect and characterize such lesions.

Since the mid 1970s, there has been a great revolution in the imaging technology of the liver. The clinicians are confronted by a many expensive tests for the evaluation of focal and diffuse hepatic disease. A large part of literature has addressed this issue in an attempt to find the one best imaging study.