Diagnosis of primary liver cancer using ct scan and mri
,1,* Mohammad hossein jamshidi
1. Department of Radiologic Technology, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2. Department of Radiologic Technology, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Liver imaging is commonly undertaken in patients with cancer history because, after lymph nodes, the liver is the most frequently involved organ by metastases. liver metastases most often arise from primary tumors in colon, breast, lung, pancreas and stomach. several imaging modalities are now available for detection and characterisation of focal liver lesions. the development of high-speed helical computed tomography (ct) and organ-specific scanning protocols has markedly improved preoperative ct staging of liver tumors. three-dimensional reconstruction and arterial and venous imaging without invasive arterial angiography can be accomplished with currently available equipment and software programs.
Publications were retrieved by a systematic search of multiple bibliographic databases, including medline, embase, scopus, cochrane library, web of science, biomed central, science direct, and google scholar. the language of search was restricted to english.
For hepatocellular carcinoma (hcc), the helical ct detection rate for small tumors (40% to 60%) is less than that for hepatic metastases, owing to the difficulty of detecting small tumors in cirrhotic livers and particularly of distinguishing hcc from macroregenerative nodules. further improvements in morphologic ct imaging over the next 5 years will include rapid data acquisition during a single breath-hold, rapid scan sections with thinner individual sections, multidetector systems, and multiplanar 3- dimensional reconstructions and volume rendering with even more detailed image resolution. magnetic resonance (mr) imaging is more sensitive than helical ct in the detection of early hcc and in distinguishing between hcc and macro regenerative nodules. the development of liver-specific mr imaging contrast agents has further improved the diagnostic accuracy in both primary and metastatic liver malignancies, and such agents can also help establish the probability of a benign versus a malignant liver tumor. the goal of liver imaging in oncologic patients includes liver tumor detection and characterisation. patients with extra-hepatic malignancy undergo survey examinations to exclude the presence of hepatic and extrahepatic metastases and to evaluate the extent of local involvement.this metastasis survey should be done with contrast-enhanced ct, mri being reserved for those patients unable to receive intravenous contrast or with a fatty liver. patients with hepatic metastases being considered for metastasectomy undergo a staging examination usually with contrast-enhanced mri using tissue-specific contrast agents.
Finally, preoperative mapping of the hepatic artery, portal vein and the hepatic vein anatomy is often undertaken before surgery in patients with hepatic malignancy. vascular anatomy imaging can be done with ct angiography or mr angiography, and generally requires a separate examination.
Primary liver cancer, diagnosis, imaging.