Copyright ©The Author(s) 2021.
World J Hepatol. Dec 27, 2021; 13(12): 1936-1955
Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.1936
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
Lower availability
Non-cooperative patients may result in suboptimal study
Limited for pacemaker carriers
Limited use if Glomerular filtration rate < 15 mL/min
Low cost
Higher availability
Higher sensitivity compared to ultrasonography
Whole-body evaluation
Therapy response assessment
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
False negatives after a chemotherapy cycle
Lower sensitivity for small liver metastases
Lower availability
Highest ionizing radiation dose