Multimodality Approach in Detection and Characterization of Hepatic Metastases

Pooja G. Patil; Pramesh Reddy; Sudarshan Rawat; Rupa Ananthasivan; Rakesh Sinha

doi:10.1055/s-0039-3402100

Journal of Gastrointestinal and Abdominal Radiology, Table of Contents

CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2020; 03(02): 163-180
DOI: 10.1055/s-0039-3402100

Review Article

Multimodality Approach in Detection and Characterization of Hepatic Metastases

Pooja G. Patil

¹Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India

,

Pramesh Reddy

¹Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India

,

Sudarshan Rawat

¹Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India

,

Rupa Ananthasivan

¹Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India

,

Rakesh Sinha

²Department of Radiology, South Warwickshire NHS Foundation Trust, Warwick, United Kingdom

› Author Affiliations

Abstract

Early detection of liver metastases is important in patients with known primary malignancies. This plays an important role in treatment planning and impacts on further management of certain primary malignancies.

Magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography-computed tomography scans are reported to have high accuracy in the diagnosis of intrahepatic lesions. MRI in particular has the advantages of its high tissue sensitivity and its multiparametric approach.

Hepatic metastatic lesions have considerable overlap in their radiological appearance, and in this article the imaging appearance of various hepatic metastasis and approach is described.

Keywords

hepatic metastases - MRI - CT

Full Text

References

References
1 Schwartz SI. Liver. In: Schwartz SI, Shires TG, Spencer FC, et al., eds. Principles of Surgery. 7th ed. New York, NY: McGraw-Hill, Health Professions Division. 1999: 1411
2 Jones EC, Chezmar JL, Nelson RC, Bernardino ME. The frequency and significance of small (less than or equal to 15 mm) hepatic lesions detected by CT. Am J Roentgenol 1992; 158 (03) 535-539
3 Schwartz LH, Gandras EJ, Colangelo SM, Ercolani MC, Panicek DM. Prevalence and importance of small hepatic lesions found at CT in patients with cancer. Radiology 1999; 210 (01) 71-74
4 Thyavihally YB, Mahantshetty U, Chamarajanagar RS, Raibhattanavar SG, Tongaonkar HB. Management of renal cell carcinoma with solitary metastasis. World J Surg Oncol 2005; 3: 48
5 Kamel IR, Kruskal JB, Warmbrand G, Goldberg SN, Pomfret EA, Raptopoulos V. Accuracy of volumetric measurements after virtual right hepatectomy in potential donors undergoing living adult liver transplantation. AJR Am J Roentgenol 2001; 176 (02) 483-487
6 Expert Panel on Gastrointestinal Imaging; Kaur H, Hindman NM, Al-Refaie WB. Suspected liver metastases. J Am Coll Radiol 2017;14(5):S314–S325
7 Floriani I, Torri V, Rulli E. et al. Performance of imaging modalities in diagnosis of liver metastases from colorectal cancer: a systematic review and meta-analysis. J Magn Reson Imaging 2010; 31 (01) 19-31
8 Albrecht T, Blomley MJ, Burns PN. et al. Improved detection of hepatic metastases with pulse-inversion US during the liver-specific phase of SHU 508A: multicenter study. Radiology 2003; 227 (02) 361-370
9 Bartolotta TV, Midiri M, Quaia E. et al. Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US. Eur Radiol 2005; 15 (04) 685-693
10 Celli N, Gaiani S, Piscaglia F. et al. Characterization of liver lesions by real-time contrast-enhanced ultrasonography. Eur J Gastroenterol Hepatol 2007; 19 (01) 3-14
11 Dietrich CF, Kratzer W, Strobe D. et al. Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI. World J Gastroenterol 2006; 12 (11) 1699-1705
12 Dietrich CF, Mertens JC, Braden B, Schuessler G, Ott M, Ignee A. Contrast-enhanced ultrasound of histologically proven liver hemangiomas. Hepatology 2007; 45 (05) 1139-1145
13 Lanka B, Jang HJ, Kim TK, Burns PN, Wilson SR. Impact of contrast-enhanced ultrasonography in a tertiary clinical practice. J Ultrasound Med 2007; 26 (12) 1703-1714
14 Luo W, Numata K, Morimoto M. et al. Focal liver tumors: characterization with 3D perflubutane microbubble contrast agent-enhanced US versus 3D contrast-enhanced multidetector CT. Radiology 2009; 251 (01) 287-295
15 Trillaud H, Bruel JM, Valette PJ. et al. Characterization of focal liver lesions with SonoVue-enhanced sonography: international multicenter-study in comparison to CT and MRI. World J Gastroenterol 2009; 15 (30) 3748-3756
16 Vialle R, Boucebci S, Richer JP. et al. Preoperative detection of hepatic metastases from colorectal cancer: prospective comparison of contrast-enhanced ultrasound and multidetector-row computed tomography (MDCT).. Diagn Interv Imaging 2016; 97 (09) 851-855
17 Leoni S, Piscaglia F, Golfieri R. et al. The impact of vascular and nonvascular findings on the noninvasive diagnosis of small hepatocellular carcinoma based on the EASL and AASLD criteria. Am J Gastroenterol 2010; 105 (03) 599-609
18 Wilson SR, Kim TK, Jang HJ, Burns PN. Enhancement patterns of focal liver masses: discordance between contrast-enhanced sonography and contrast-enhanced CT and MRI. AJR Am J Roentgenol 2007; 189 (01) W7-W12
19 Parker GA, Lawrence Jr W, Horsley III JS. et al. Intraoperative ultrasound of the liver affects operative decision making. Ann Surg 1989; 209 (05) 569-576, discussion 576–577
20 Marcal LP, Patnana M, Bhosale P, Bedi DG. Intraoperative abdominal ultrasound in oncologic imaging. World J Radiol 2013; 5 (03) 51-60
21 Sietses C, Meijerink MR, Meijer S, van den Tol MP. The impact of intraoperative ultrasonography on the surgical treatment of patients with colorectal liver metastases. Surg Endosc 2010; 24 (08) 1917-1922
22 Kruskal JB, Kane RA. Intraoperative US of the liver: techniques and clinical applications. Radiographics 2006; 26 (04) 1067-1084
23 Silas AM, Kruskal JB, Kane RA. Intraoperative ultrasound. Radiol Clin North Am 2001; 39 (03) 429-448
24 D’Onofrio M, Vecchiato F, Faccioli N, Falconi M, Pozzi Mucelli R. Ultrasonography of the pancreas. 7. Intraoperative imaging. Abdom Imaging 2007; 32 (02) 200-206
25 Penna C, Nordlinger B. Surgery of liver metastases from colorectal cancer: new promises. Br Med Bull 2002; 64: 127-140
26 Conlon R, Jacobs M, Dasgupta D, Lodge JP. The value of intraoperative ultrasound during hepatic resection compared with improved preoperative magnetic resonance imaging. Eur J Ultrasound 2003; 16 (03) 211-216
27 Wagnetz U, Atri M, Massey C, Wei AC, Metser U. Intraoperative ultrasound of the liver in primary and secondary hepatic malignancies: comparison with preoperative 1.5-T MRI and 64-MDCT. AJR Am J Roentgenol 2011; 196 (03) 562-568
28 Kartalis N, Brismar TB, Mihocsa L, Isaksson B, Albiin N. The added value of contrast-enhanced ultrasound in patients with colorectal cancer undergoing preoperative evaluation with extensive gadobenate dimeglumine liver MRI. Eur Radiol 2011; 21 (10) 2067-2073
29 Kim HO, Kim SK, Son BH. et al. Intraoperative radiofrequency ablation with or without tumorectomy for hepatocellular carcinoma in locations difficult for a percutaneous approach. Hepatobiliary Pancreat Dis Int 2009; 8 (06) 591-596
30 Crucitti A, Danza FM, Antinori A. et al. Radiofrequency thermal ablation (RFA) of liver tumors: percutaneous and open surgical approaches. J Exp Clin Cancer Res 2003; 22 (4, Suppl) 191-195
31 Soyer P, Poccard M, Boudiaf M. et al. Detection of hypovascular hepatic metastases at triple-phase helical CT: sensitivity of phases and comparison with surgical and histopathologic findings. Radiology 2004; 231 (02) 413-420
32 Kuszyk BS, Bluemke DA, Urban BA. et al. Portal-phase contrast-enhanced helical CT for the detection of malignant hepatic tumors: sensitivity based on comparison with intraoperative and pathologic findings. AJR Am J Roentgenol 1996; 166 (01) 91-95
33 Bonaldi VM, Bret PM, Reinhold C, Atri M. Helical CT of the liver: value of an early hepatic arterial phase. Radiology 1995; 197 (02) 357-363
34 Hollett MD, Jeffrey Jr RB, Nino-Murcia M, Jorgensen MJ, Harris DP. Dual-phase helical CT of the liver: value of arterial phase scans in the detection of small (< or = 1.5 cm) malignant hepatic neoplasms. AJR Am J Roentgenol 1995; 164 (04) 879-884
35 Sica GT, Ji H, Ros PR. CT and MR imaging of hepatic metastases. AJR Am J Roentgenol 2000; 174 (03) 691-698
36 Wicherts D, de Haas R, van Kessel C, Bisschops R, Takahara T, van Hillegersberg R. et al. Incremental value of arterial and equilibrium phase compared to hepatic venous phase CT in the preoperative staging of colorectal liver metastases: an evaluation with different reference standards. Eur J Radiol 2011; 77 (02) 305-311
37 Detection of hypovascular hepatic metastases at triple-phase helical CT: sensitivity of phases and comparison with surgical and histopathologic findings. Radiology. 2004;231(2):413-420
38 Honda Y, Higaki T, Higashihori H. et al. Re-evaluation of detectability of liver metastases by contrast-enhanced CT: added value of hepatic arterial phase imaging. Jpn J Radiol 2014; 32 (08) 467-475
39 Silverman P. Liver metastases: imaging considerations for protocol development with multislice CT (MSCT).. Cancer Imaging 2006; 6: 175-181
40 Ko Y, Kim J, Park JK. et al. Limited detection of small (≤ 10 mm) colorectal liver metastasis at preoperative CT in patients undergoing liver resection. PLoS One 2017; 12 (12) e0189797
41 Radiology Key. Liver metastases. 2019. Available at: https:// radiologykey.com/liver-metastases-2. Accessed Nov 12, 2019
42 Soyer P, Bluemke DA, Vissuzaine C, Beers BV, Barge J, Levesque M. CT of hepatic tumors: prevalence and specificity of retraction of the adjacent liver capsule. AJR Am J Roentgenol 1994; 162 (05) 1119-1122
43 Apicella PL, Mirowitz SA, Weinreb JC. Extension of vessels through hepatic neoplasms: MR and CT findings. Radiology 1994; 191 (01) 135-136
44 Seale MK, Catalano OA, Saini S, Hahn PF, Sahani DV. Hepatobiliary-specific MR contrast agents: role in imaging the liver and biliary tree. Radiographics 2009; 29 (06) 1725-1748
45 Baum S. Hepatic arteriography. In: Baum S, ed. Abram’s Angiography 4th ed. Boston: Little Brown 1997: 1433-1456
46 Nino-Murcia M, Olcott EW, Jeffrey Jr RB, Lamm RL, Beaulieu CF, Jain KA. Focal liver lesions: pattern-based classification scheme for enhancement at arterial phase CT. Radiology 2000; 215 (03) 746-751
47 Semelka RC, Braga L, Armao D. et al. Liver. In: Semelka RC, ed. Abdominal-Pelvic MRI. 1st ed. New York, NY: Wiley-Liss 2002: 101-134
48 Mahfouz AE, Hamm B, Wolf KJ. Peripheral washout: a sign of malignancy on dynamic gadolinium-enhanced MR images of focal liver lesions. Radiology 1994; 190 (01) 49-52
49 Danet IM, Semelka RC, Leonardou P. et al. Spectrum of MRI appearances of untreated metastases of the liver. AJR Am J Roentgenol 2003; 181 (03) 809-817
50 Semelka RC, Brown ED, Ascher SM. et al. Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology 1994; 192 (02) 401-406
51 Semelka RC, Hussain SM, Marcos HB, Woosley JT. Perilesional enhancement of hepatic metastases: correlation between MR imaging and histopathologic findings-initial observations. Radiology 2000; 215 (01) 89-94
52 Hussain SM, De J Becker, Hop WC, Dwarkasing S, Wielopolski PA. Can a single-shot black-blood T2-weighted spin-echo echo-planar imaging sequence with sensitivity encoding replace the respiratory-triggered turbo spin-echo sequence for the liver? An optimization and feasibility study. J Magn Reson Imaging 2005; 21 (03) 219-229
53 Koh DM, Brown G, Riddell AM. et al. Detection of colorectal hepatic metastases using MnDPDP MR imaging and diffusion-weighted imaging (DWI) alone and in combination. Eur Radiol 2008; 18 (05) 903-910
54 Diffusion-weighted MR imaging of the liver | radiology. Pubs.rsna.org. 2019. Available at: https://pubs.rsna.org/doi/abs/10.1148/radiol.09090021. Accessed July 21, 2019
55 Park YS, Lee CH, Kim JW, Shin S, Park CM. Differentiation of hepatocellular carcinoma from its various mimickers in liver magnetic resonance imaging: what are the tips when using hepatocyte-specific agents?. World J Gastroenterol 2016; 22 (01) 284-299
56 Han JK, Choi BI, Kim AY. et al. Cholangiocarcinoma: pictorial essay of CT and cholangiographic findings. Radiographics 2002; 22 (01) 173-187
57 Chua SC, Groves AM, Kayani I. et al. The impact of 18F-FDG PET/CT in patients with liver metastases. Eur J Nucl Med Mol Imaging 2007; 34 (12) 1906-1914
58 Wiering B, Krabbe PF, Jager GJ, Oyen WJ, Ruers TJ. The impact of fluor-18-deoxyglucose-positron emission tomography in the management of colorectal liver metastases. Cancer 2005; 104 (12) 2658-2670
59 Kinkel K, Lu Y, Both M, Warren RS, Thoeni RF. Detection of hepatic metastases from cancers of the gastrointestinal tract by using noninvasive imaging methods (US, CT, MR imaging, PET): a meta-analysis. Radiology 2002; 224 (03) 748-756
60 Grassetto G, Fornasiero A, Bonciarelli G. et al. Additional value of FDG-PET/CT in management of “solitary” liver metastases: preliminary results of a prospective multicenter study. Mol Imaging Biol 2010; 12 (02) 139-144
61 Kong G, Jackson C, Koh DM. et al. The use of 18F-FDG PET/CT in colorectal liver metastases—comparison with CT and liver MRI. Eur J Nucl Med Mol Imaging 2008; 35 (07) 1323-1329
62 Fong Y, Saldinger PF, Akhurst T. et al. Utility of 18F-FDG positron emission tomography scanning on selection of patients for resection of hepatic colorectal metastases. Am J Surg 1999; 178 (04) 282-287
63 Rohren EM, Paulson EK, Hagge R. et al. The role of F-18 FDG positron emission tomography in preoperative assessment of the liver in patients being considered for curative resection of hepatic metastases from colorectal cancer. Clin Nucl Med 2002; 27 (08) 550-555
64 Ruers TJ, Langenhoff BS, Neeleman N. et al. Value of positron emission tomography with [F-18] fluorodeoxyglucose in patients with colorectal liver metastases: a prospective study. J Clin Oncol 2002; 20 (02) 388-395
65 Sahani DV, Kalva SP, Fischman AJ. et al. Detection of liver metastases from adenocarcinoma of the colon and pancreas: comparison of mangafodipir trisodium-enhanced liver MRI and whole-body FDG PET. AJR Am J Roentgenol 2005; 185 (01) 239-246
66 Sacks A, Peller PJ, Surasi DS, Chatburn L, Mercier G, Subramaniam RM. Value of PET/CT in the management of liver metastases, part 1. AJR Am J Roentgenol 2011; 197 (02) W256-W259
67 Goldberg SN, Gazelle GS, Compton CC, Mueller PR, Tanabe KK. Treatment of intrahepatic malignancy with radiofrequency ablation: radiologic-pathologic correlation. Cancer 2000; 88 (11) 2452-2463
68 Limanond P, Zimmerman P, Raman SS, Kadell BM, Lu DS. Interpretation of CT and MRI after radiofrequency ablation of hepatic malignancies. AJR Am J Roentgenol 2003; 181 (06) 1635-1640
69 Dromain C, de Baere T, Elias D. et al. Hepatic tumors treated with percutaneous radio-frequency ablation: CT and MR imaging follow-up. Radiology 2002; 223 (01) 255-262
70 Lubezky N, Metser U, Geva R. et al. The role and limitations of 18-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and computerized tomography (CT) in restaging patients with hepatic colorectal metastases following neoadjuvant chemotherapy: comparison with operative and pathological findings. J Gastrointest Surg 2007; 11 (04) 472-478
71 Eisenberg BL, Harris J, Blanke CD. et al. Phase II trial of neoadjuvant/adjuvant imatinib mesylate (IM) for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor (GIST): early results of RTOG 0132/ACRIN 6665. J Surg Oncol 2009; 99 (01) 42-47
72 Choi H, Charnsangavej C, de Castro Faria S. et al. CT evaluation of the response of gastrointestinal stromal tumors after imatinib mesylate treatment: a quantitative analysis correlated with FDG PET findings. AJR Am J Roentgenol 2004; 183 (06) 1619-1628
73 Abdulkader I, Cameselle-Teijeiro J, Forteza J. Pathological changes related to imatinib treatment in a patient with a metastatic gastrointestinal stromal tumour. Histopathology 2005; 46 (04) 470-472
74 Shankar S, vanSonnenberg E, Desai J. Dipiro PJ, Van Den Abbeele A, Demetri GD. Gastrointestinal stromal tumor: new nodule-within-a-mass pattern of recurrence after partial response to imatinib mesylate. Radiology 2005; 235 (03) 892-898