Hepatic neoplasms: surgically relevant segmental anatomy and imaging techniques

With advances in imaging and surgical techniques, the diagnosis and treatment of primary and secondary liver neoplasms have improved. Advances in imaging have contributed to the early detection of the tumors and have allowed more precise preoperative characterization and localization of the lesions. Refinements in surgical technique have permitted more extensive resections, while at the same time placing even greater importance on accurate preoperative imaging of the tumor. Presurgical planning requires precise definition of the extent of the tumor vis-à-vis hepatic segmental anatomy. The goal of this essay is to discuss the segmental anatomy of the liver, the types of segmental resections possible, and the strengths and weaknesses of the various imaging techniques used in the preoperative assessment of potential candidates for hepatic resection. Staging of hepatic malignant tumors and technical details of the imaging techniques are not discussed.