Optimal imaging of focal liver lesions

Modern diagnostic imaging allows the accurate identification of different focal liver lesions. Ultrasound and contrast-enhanced ultrasound are widely available, and contrast injection allows the classification of most lesions as benign or malignant. CT is a robust, widely available and easy-to-use imaging technique that allows studies to be conducted in uncooperative patients. Owing to different sequences and liver-specific contrast agents, MRI is able to not only provide morphological and vascular information of the focal liver lesions, but also functional information on the capacity of the lesion to uptake the liver-specific contrast agent. The main drawback of the technique is the requirement for state-of-the-art equipment and a good knowledge of the different contrast mechanisms. Owing to the different costs and availability of the imaging techniques, their correct utilization permits a precise, accurate and fast way to gain the most significant information, thus allowing correct management of the different patients.