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| Author | Salvatore Azzopardi |
| Abstract | Metastases are the most common cause of malignancy in the liver. Although clinical evaluation may play a role, its diagnosis relies mostly on radiological imaging. Ultrasound (US), Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Radionuclide Imaging (RNI) and Positron Emission Tomography (PET) all contribute to the evaluation of liver metastases and ultimately to better prognosis. An extensive literature review was undertaken in order to evaluate the sensitivity and specificity of different imaging modality in differentiating liver metastasis which are 1 cm or larger in diameter. The results obtained were compared and discussed with surgical inspection and pathological findings to help establish the accuracy of each imaging modality. Since it is not expensive, readily available, and makes use of non-ionising radiation, US is usually the first choice of investigation. However, due to its low sensitivity it is inconclusive. Ferumoxides enhanced MRI was found to be slightly more accurate than Spiral CT Arterial Portography. PET was shown to be the most accurate imaging modality. However, being very expensive it is only available in few institutions/ hospitals. The majority of literature reviewed concluded that the imaging modalities in current use are sensitive for lesions greater than 1 cm in size. Thus, the challenge is to detect smaller lesions. Finally, on the basis of literature reviewed, recommendations for an imaging strategy" when liver metastasis is suspected in relation to the current situation in Malta were proposed. |
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| Key words | Radiography, Thesis, Imaging, Liver Metastases |