Introduction to Liver Cancer
Imaging of the liver is carried out for the detection and characterization of suspected primary or secondary neoplasms prior to planning surgery or chemotherapy, for the staging of neoplasms, for assessing treatment response, for evaluating biliary pathology, and for screening liver neoplasms in high-risk patients. Imaging also provides the assessment of vascular anatomy of the liver for surgical scheduling and diagnosis and treatment by guided procedures including percutaneous biopsy, radiofrequency ablation (RFA), hepatic artery infusion therapy, and transarterial chemoembolization (TACE).
Although liver ultrasonography (US) is still the first choice investigation, the role of CT and magnetic resonance imaging (MRI) has been recognized as the main imaging modalities. Contrast-enhanced multidetector CT (MDCT) and MRI are frequently used to estimate the tumor burden, vascular or biliary invasion, and residual normal liver volume and evaluate patients with preexisting liver disease (chronic hepatitis or cirrhosis) in order to search for development of potential primary malignancies. Further, the advances in 18-fluorodeoxyglucose positron emission tomography (18-FDG-PET) have also added a new dimension to functional liver imaging.
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