Diagnosis of Liver Metastasis

Focal liver disease may be detected incidentally during cross-sectional imaging studies, at the time of cancer screening or follow-up and during laparotomy. Where surgery is being undertaken for colorectal cancer, for example, 26% of patients may be expected to have liver metastases and while a metastasis is the most common liver tumour detected and the majority arise from a colorectal primary cancer, some of the lesions found will represent benign disease of no clinical significance. A number of benign processes, such as haemangiomas and cysts, can mimic metastatic disease closely and in order that the most appropriate management is applied, it is clearly of paramount importance that an accurate distinction is made between significant and insignificant disease. Accurate characterization of a focal liver lesion, e.g. a simple cyst, may be possible using conventional ultrasound alone while other more complex pathologies may require multiple imaging studies and biopsy before a confident diagnosis can be made.