Solid liver masses: approach to management from the standpoint of a radiologist

Solid liver masses are being discovered at increasing rates due to the widespread use of medical imaging. Ultrasound, computed tomography, and magnetic resonance imaging play important and often complementary roles in detecting and diagnosing solid liver masses. Morphologic and enhancement characteristics as well as clinical history frequently allow a confident imaging diagnosis. Still, diagnosing liver masses with imaging alone remains a challenge, and masses that do not meet specific diagnostic criteria may require biopsy. Newly developed standardized terminology and imaging criteria have facilitated the imaging diagnosis of hepatocellular carcinoma (HCC) in patients with cirrhosis. Hepatobiliary-secreted MRI contrast agents have improved the ability to diagnose focal nodular hyperplasia and may also improve the detection and imaging diagnosis of HCC. These exciting new contrast agents are the subject of active investigation.