Preliminary Diagnosis: Liver Metastases
I. What imaging technique is first-line for this diagnosis?
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Ultrasound of the liver
II. Describe the advantages and disadvantages of this technique for diagnosis of liver metastases.
Advantages
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Highly portable, relatively quick imaging modality
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Does not expose patients to ionizing radiation
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Better adept in detailing the vascularity of a lesion than other imaging modalities
Disadvantages
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Limited in sensitivity and specificity in detecting, characterizing, and diagnosing hepatic lesions
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May help guide percutaneous biopsy, treatment, and therapy
III. What are the contraindications for the first-line imaging technique?
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No specific contraindications to sonographic imaging exist.
IV. What alternative imaging techniques are available?
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Triple phase liver protocol CT imaging of the liver
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Triple phase MR imaging of the abdomen and pelvis with contrast per liver protocol
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of liver metastases.
Triple phase liver protocol CT imaging of the liver
Advantages
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Highly sensitive and specific in diagnosing, characterizing, and detecting liver lesions
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May help guide percutaneous biopsy, treatment, and therapy
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Offers exquisite visualization of the surrounding soft tissues , osseous structures, and vasculature
Disadvantages
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Exposes patients to ionizing radiation
Triple phase MR imaging of the abdomen and pelvis with contrast per liver protocol
Advantages
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Does not expose patients to ionizing radiation
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Offers exquisite visualization of the surrounding soft tissues
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Eovist contrast medium may better delineate biliary versus hepatic pathology
Disadvantages
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Offers limited evaluation of the surrounding osseous structures
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May be subject to motion and susceptibility weighted artifact degrading image quality
VI. What are the contraindications for the alternative imaging techniques?
Triple phase liver protocol CT imaging of the liver
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May be contraindicated in patients who are pregnant
Triple phase MR imaging of the abdomen and pelvis with contrast per liver protocol
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Contraindicated in patients with non-MR compatible hardware
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