[Diagnosis and staging of liver metastases with imaging methods]

Liver metastases are much more common than primary hepatic malignancies and may occur in up to 80% of patients with extrahepatic malignancies. To optimize the patient's management, precise detection or exclusion of liver metastases, as well as assessment of their number and extent, is indispensable. For imaging of liver metastases, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), scintigraphy, and angiography can be utilized. All these methods have been technically improved with benefits for diagnostic utility. Biphasic contrast-enhanced spiral CT (SCT) and MRI with modern pulse sequences and tissue-specific contrast agents are superior to other imaging modalities in terms of diagnostic efficacy and reproducibility of results. With SCT and MRI sensitivities and specificities in the diagnosis of focal hepatic disease are in the range of 80-95%. Moreover, their non-invasiveness is a strong advantage. The diagnostic strategy in the assessment of liver metastases has to take into account both the strengths and limitations of the respective method. Additionally, the clinical situation of a particular patient has to be considered, and conclusive diagnostic results have to be achieved in a short time in order to ensure a favourable cost-effectiveness relation.