Colorectal cancer liver metastases: A radiologic point of view

Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide. Despite advances in early detection and treatment, approximately half of patients with CRC develop liver metastases (LM), complicating therapeutic strategies and reducing survival rates. Radiological imaging is critical in managing colorectal LM by guiding detection, staging, treatment planning, and response evaluation. This letter to the editor provides a comprehensive overview of both traditional and emerging imaging modalities, including computed tomography, magnetic resonance imaging, and positron emission tomography, and their specific roles in clinical decision-making. It further explores advanced techniques such as radiomics, artificial intelligence, and radiogenomics, which integrate quantitative imaging features with genetic and clinical data to enhance prognostication and tailor personalized treatment approaches. Specific examples of how these innovations are applied in treatment response assessment and pre-surgical planning are highlighted. The discussion also emphasizes the need for large-scale prospective clinical trials and standardized protocols to validate current predictive models and fully integrate these advanced methodologies into clinical practice.