Progressive CT appearance of hepatic metastases from colorectal carcinoma

An 8-year retrospective review of 106 serial computed tomographic (CT) examinations performed on 32 patients with colorectal carcinoma metastatic to the liver was done to determine if the CT appearance of such metastases changed with a favorable response to chemotherapy or with progression of disease. Of these 32 patients, 15 underwent placement of an infusion pump for delivery of chemotherapy directly into the hepatic artery, 3 underwent partial hepatectomy, 1 underwent both procedures, and 13 underwent neither. Regression of hepatic metastases (7 patients), only seen following infusion pump placement, was associated with a decrease in size and an increase in margination of lesions. In two of these patients regression of metastases was seen in one area of the liver with subsequent progression or development of metastases in another region, presumably due to preferential delivery of chemotherapeutic agent. Progression of disease (23 patients) was associated with an increase in both size and number of lesions that became progressively less well marginated. Development of poorly marginated or infiltrative characteristics at the periphery of the lesion was associated with a poor prognosis. Thus, the CT characteristics of hepatic metastases from colorectal carcinoma differ with a favorable response to chemotherapy and with progression of disease.