title: Magnetic Resonance Imaging of Liver Metastasis.
abstract: Liver magnetic resonance imaging (MRI) is becoming the gold standard in liver metastasis detection and treatment response assessment. The most sensitive magnetic resonance sequences are diffusion-weighted images and hepatobiliary phase images after Gd-EOB-DTPA. Peripheral ring enhancement, diffusion restriction, and hypointensity on hepatobiliary phase images are hallmarks of liver metastases. In patients with normal ultrasonography, computed tomography (CT), and positron emission tomography (PET)-CT findings and high clinical suspicion of metastasis, MRI should be performed for diagnosis of unseen metastasis. In melanoma, colon cancer, and neuroendocrine tumor metastases, MRI allows confident diagnosis of treatment-related changes in liver and enables differential diagnosis from primary liver tumors. Focal nodular hyperplasia-like nodules in patients who received platinum-based chemotherapy, hypersteatosis, and focal fat can mimic metastasis. In cancer patients with fatty liver, MRI should be preferred to CT. Although the first-line imaging for metastases is CT, MRI can be used as a problem-solving method. MRI may be used as the first-line method in patients who would undergo curative surgery or metastatectomy. Current limitation of MRI is low sensitivity for metastasis smaller than 3mm. MRI fingerprinting, glucoCEST MRI, and PET-MRI may allow simpler and more sensitive diagnosis of liver metastasis.
authors.affiliation: Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Ali Devrim
authors.initials: AD
authors.lastname: Karaosmanoglu
authors.affiliation: Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Mehmet Ruhi
authors.initials: MR
authors.lastname: Onur
authors.affiliation: Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Mustafa Nasuh
authors.initials: MN
authors.lastname: Ozmen
authors.affiliation: Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Akata
authors.affiliation: Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey. Electronic address: musturayk@yahoo.com.
authors.forename: Musturay
authors.initials: M
authors.lastname: Karcaaltincaba
mesh_terms: D003287:Contrast Media / Q000493:pharmacokinetics; D003937:Diagnosis, Differential; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media