Imaging evaluation of the liver in oncology patients: A comparison of techniques

Table 1 Deciding between different imaging methods for liver metastasis diagnosis based on articles’ analysis

Imaging methods	Critical details
MRI	Pros:
	Most accurate method, and superior to CT and PET-CT for the detection of liver metastases:
	Especially useful for smaller lesions (< 1 cm), characterization of hypervascular metastases, and in the setting of liver steatosis
	High grade of confidence in the distinction between malignant and benign lesions
	Anatomic and morphologic evaluation.
	Non-enhancing sequences play an important role
	Therapy response assessment
	Absence of ionizing radiation
	Less allergic reactions
	May be the most cost-effective option:
	Higher detection rate > more curative approach > avoids additional imaging examinations
	Cons:
	Lower availability
	Non-cooperative patients may result in suboptimal study
	Limited for pacemaker carriers
	Limited use if Glomerular filtration rate < 15 mL/min
CT	Pros:
	Low cost
	Higher availability
	Higher sensitivity compared to ultrasonography
	Whole-body evaluation
	Therapy response assessment
	Cons:
	Ionizing radiation
	Lower sensitivity for the detection of smaller metastases or in the setting of liver steatosis compared to MRI
	Low confidence in the distinction between malignant and benign lesions
	Not adequate for renal impaired patients
PET-CT	Pros:
	Accurate detection of extrahepatic disease
	Therapy response assessment
	Cons:
	False negatives after a chemotherapy cycle
	Lower sensitivity for small liver metastases
	Lower availability
	Highest ionizing radiation dose

MRI: Magnetic resonance imaging; CT: Computed tomography; PET-CT: Positron emission tomography-computed tomography.