Viera Lehotská
Diagnostic imaging methods are focused first on the detection and on tissue characteristics of suspect primary and/or secondary liver tumors, especially for planning surgical therapy, for overall staging of the disease, monitoring therapeutical responses, then evaluating bile ducts and on screening of malignancy in high risk population. Ultrasound (US), multidetector computer-assisted tomography (MDCT) and magnetic resonance imaging (MRI) are routinely used in imaging algorithm. MRI should be performed before any invasive procedure (biopsy). Mean advantages of MRI are better tissue resolution, multiplanar imaging feasibility (nowadays also possible with the newest CT equipments), and absence of radiation, minimal risk of allergic reaction after contrast administration and especially the use of hepatotropic contrast media. On the other sidee, the disadvantage of MRI is a limited examination in patients with metallic implants and absolute contraindication in patients with electronic implants. The benefit in differential diagnosis is the use of organ-specific contrast agents, witch are helpful for determination of the tumor structure, but for the clinical practice the goal remains the determination of benign or malignant tumor characteristics, what is of great mean for the further therapeutical and prognostic approach.