title: Approach to the Solitary Liver Lesion: Imaging and When to Biopsy.
abstract: The characterization and management of focal liver lesions is a commonly encountered problem in radiology. While the imaging findings will often be diagnostic, in equivocal cases the decision of how to proceed may be challenging. The primary modalities for liver lesion characterization are multiphase contrast-enhanced computed tomography and magnetic resonance imaging. Most lesions have typical imaging features, and when taken in conjunction with patient demographics and biochemistry the diagnosis can usually be made. Ancillary imaging modalities such as contrast-enhanced ultrasound and hepatobiliary specific contrast agents are also useful. Cirrhotic livers present a challenge due to the spectrum of benign, dysplastic, and malignant nodules that can occur. The report should include information necessary for accurate staging, and published standardized reporting guidelines should be taken into consideration. A decision to proceed to biopsy should be made only after multidisciplinary review of the case. If biopsy is required, fine needle aspiration is usually sufficient, though core needle biopsy may be required in certain circumstances.
authors.affiliation: Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: Emily.Pang3@vch.ca.
authors.forename: Emily H T
authors.initials: EH
authors.lastname: Pang
authors.affiliation: Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Alison C
authors.initials: AC
authors.lastname: Harris
authors.affiliation: Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Silvia D
authors.initials: SD
authors.lastname: Chang
mesh_terms: D044963:Biopsy, Fine-Needle; D003287:Contrast Media; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D007089:Image Enhancement; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media
keywords: Carcinoma; Hepatocellular; Image-guided biopsy; Liver cirrhosis; Liver neoplasms; Magnetic resonance imaging