Small liver lesions in oncologic patients: characterization with CT, MRI and contrast-enhanced US

Focal liver lesions (FLLs) are frequently discovered during ultrasound examinations either in healthy subjects without a clinical history of cancer or during staging or follow-up procedures in oncologic patients or in routine surveillance of hepatopathic patients. In oncologic patients, the liver is the most common target of metastatic disease and accurate detection and characterisation of FLLs is prognostically fundamental during the initial staging as well as before and after pre-operative chemotherapy, as it can help to identify patients who are most likely to benefit from liver surgery. Moreover, early detection of primary or secondary liver malignancies increases the possibility of curative surgical resection or successful percutaneous ablation. As many FLLs in these patients are benign, a precise and preferably non-invasive method of differentiation from malignant metastatic nodules is needed. Moreover, the continuous follow-up of cancer patients requires an easily available, reliable and cost-effective diagnostic tool for the detection and characterization of FLLs.