Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2015; 7(7): 157-169
Published online Jul 28, 2015. doi: 10.4329/wjr.v7.i7.157
Non-invasive diagnostic imaging of colorectal liver metastases
Pier Paolo Mainenti, Federica Romano, Laura Pizzuti, Sabrina Segreto, Giovanni Storto, Lorenzo Mannelli, Massimo Imbriaco, Luigi Camera, Simone Maurea
Pier Paolo Mainenti, Laura Pizzuti, IBB CNR, 80145 Naples, Italy
Federica Romano, Sabrina Segreto, Massimo Imbriaco, Luigi Camera, Simone Maurea, Advanced Biomedical Science Department, Radiology Section, University of Naples “Federico II”, 80145 Naples, Italy
Giovanni Storto, IRCCS, CROB, 85028 Rionero in Vulture, Italy
Lorenzo Mannelli, Radiology Department, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, United States
Author contributions: All authors contributed to this paper.
Conflict-of-interest statement: The review has not been published before, is not under consideration for publication elsewhere and its publication has been approved by all co-authors. All the authors do not have any conflicting interests (including but not limited to commercial, personal, political, intellectual, or religious interests) related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pier Paolo Mainenti, MD, IBB CNR, Via De Amicis, 95, 80145 Naples, Italy. pierpamainenti@hotmail.com
Telephone: +39-081-7613060 Fax: +39-081-7616013
Received: January 28, 2015
Peer-review started: January 29, 2015
First decision: April 27, 2015
Revised: May 10, 2015
Accepted: June 1, 2015
Article in press: June 2, 2015
Published online: July 28, 2015
Processing time: 171 Days and 15.6 Hours
Abstract

Colorectal cancer is one of the few malignant tumors in which synchronous or metachronous liver metastases [colorectal liver metastases (CRLMs)] may be treated with surgery. It has been demonstrated that resection of CRLMs improves the long-term prognosis. On the other hand, patients with un-resectable CRLMs may benefit from chemotherapy alone or in addition to liver-directed therapies. The choice of the most appropriate therapeutic management of CRLMs depends mostly on the diagnostic imaging. Nowadays, multiple non-invasive imaging modalities are available and those have a pivotal role in the workup of patients with CRLMs. Although extensive research has been performed with regards to the diagnostic performance of ultrasonography, computed tomography, positron emission tomography and magnetic resonance for the detection of CRLMs, the optimal imaging strategies for staging and follow up are still to be established. This largely due to the progressive technological and pharmacological advances which are constantly improving the accuracy of each imaging modality. This review describes the non-invasive imaging approaches of CRLMs reporting the technical features, the clinical indications, the advantages and the potential limitations of each modality, as well as including some information on the development of new imaging modalities, the role of new contrast media and the feasibility of using parametric image analysis as diagnostic marker of presence of CRLMs.

Keywords: Advances in imaging; Colorectal cancer; Liver metastases

Core tip: The present review describes the non invasive imaging approaches of colorectal liver metastases colorectal liver metastases (CRLMs) reporting the technical features, the clinical indications, the advantages and the potential limitations of each modality [ultrasonography, computed tomography (CT); magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, PET/MRI] as well as including some information on the development of new imaging modalities, the role of new contrast media and the feasibility of using parametric image analysis as diagnostic marker of presence of CRLMs.