Preoperative Imaging in Colorectal Liver Metastases: Current Practices

Surgical resection offers the only treatment associated with long-term survival for colorectal cancer (CRC) with hepatic metastasis. Imaging studies are paramount for the identification of potential surgical candidates. Synchronous hepatic disease is identified at presentation in 20-30 % of patients and ultimately, hepatic metastases occur in over 50 % of patients diagnosed with CRC. Computed tomography (CT) has been the imaging standard to identify patients with hepatic metastasis, but the array of preoperative imaging has expanded over the past several years. Currently, ultrasound, CT, magnetic resonance imaging, and positron emission tomography all play a vital role in the management and treatment of stage IV CRC. In addition, patient characteristics such as steatosis and treatment such as neoadjuvant chemotherapy affect imaging of hepatic metastases. The goal of this review is to discuss the current standing of imaging modalities used in the perioperative care of patients with colorectal liver metastasis.