Role and limitations of magnetic resonance imaging in the diagnostic work-up of patients with liver cancer.
ABSTRACT The main objectives of liver imaging are detection and characterization of focal liver lesions. There is a wide range of imaging modalities available for the work-up of patients with liver cancer. In the current environment of cost containment, the most appropriate modality should be chosen to answer the clinical question. Contrast-enhanced computed tomography is currently the modality of choice for liver imaging for routine applications. Until recently magnetic resonance imaging was used only as a problem solving technique for lesions that were equivocal after contrast-enhanced computed tomography. However magnetic resonance with the use of tissue specific contrast agents, has already challenged the role of computed tomography portography in preoperative staging of liver cancer, and may soon completely replace this technique. It is also the primary modality for screening patients with cirrhosis for hepatocellular carcinoma. This review describes the role of magnetic resonance imaging, in the evaluation of patients with liver cancer, and outlines a rational approach for the diagnostic work-up of these patients.