A Radiologist’s Point of View in the Presurgical and Intraoperative Setting of Colorectal Liver Metastases

Abstract

Multidisciplinary management of patients with metastatic colorectal cancer requires in each phase an adequate choice of the most appropriate imaging modality. The first challenging step is liver lesions detection and characterization, using several imaging modality ultrasound, computed tomography, magnetic resonance and positron emission tomography. The criteria to establish the metastases resectability have been modified. Not only the lesions number and site but also the functional volume remnant after surgery and the quality of the nontumoral liver must be taken into account. Radiologists should identify the liver functional volume remnant and during liver surgical procedures should collaborate with the surgeon to identify all lesions, including those that disappeared after the therapy, using intraoperative ultrasound with or without contrast medium.

Keywords::

• colorectal cancer
• colorectal metastases
• computed tomography
• contrast-enhanced ultrasound
• intraoperative ultrasound
• liver
• magnetic resonance imaging
• ultrasound

Authors’ contributions

V Granata conceived of the study and participated in its design, coordination and drafting of the manuscript. R Fusco participated in the studies collection and drafted the manuscript. A Avallone, O Catalano, M Piccirillo, R Palaia, G Nasti, F Izzo and A Petrillo participated in the studies collection. All authors read and approved the final manuscript. The guarantor of the manuscript is V Granata.

Acknowledgements

The authors are grateful to A Trocino, librarian at the National Cancer Institute of Naples, Italy. Additionally, authors are grateful to LGR Guarino and A Zazzaro for their collaboration.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.