Updates in hepatic oncology imaging

The utilization of advanced imaging modalities play an important role in the detection and differentiation of benign and malignant hepatic lesions. Imaging characteristics of hepatic tumors can sometimes be atypical, often leading to diagnostic challenges. Recent technical improvements in contrast enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI) have helped to better characterize hepatic lesions. For example, contrast agents used in US can now better delineate liver lesions, while the ability to reliably produce multiplanar and 3-D reconstructions through the use of MDCT provides an additional advantage in the context of therapeutic decision making for patients with hepatic lesions. In addition, modern MR that includes the use of biliary excreted contrast material, various post-processing techniques like multiplanar reformation (MPR), as well as volume rendering (VR) allow detailed evaluation of the biliary tract, hepatic vasculature, and better characterization of hepatic tumors. As the imaging technologies available continue to evolve and advance, understanding how to effectively utilize these modalities is key to clinical practice. We herein provide a review of the various hepatic oncologic imaging modalities with a focus on how advancements and novel techniques within the different fields may be utilized in the diagnosis, treatment and management of different benign and malignant hepatic lesions.