Evaluation of the liver for metastatic disease

Metastatic disease of the liver accounts for the vast majority of detected liver masses. In patients with suspected metastatic disease, cross-sectional imaging with ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI) is critical. In the group of patients undergoing evaluation for hepatic surgery, it is even more important to optimize techniques to detect and localize metastatic disease. With improvements in technology and contrast agents, there are several approaches to imaging the liver for metastatic disease. The approach will vary by institution. This article will attempt to provide an overview of the general issues relevant to imaging metastatic disease, highlight the advantages and disadvantages of one modality compared to another, and illustrate the appearance of metastases using US, CT, and MRI.