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Imaging and therapeutic interventions in hepatic tumours.

Ultrasonography with colour Doppler is the initial modality in the work-up of a suspected hepatic tumour. Dual phase spiral CT is the next investigation for characterisation and assessment about the anatomic extent. The combined use of CT and angiography (CTA and CTAP) is the most precise imaging technique but being an invasive method it is indicated to provide vascular mapping before surgery and for transarterial embolisation of unresectable tumours. MRI is indicated in evaluation of diffuse liver disease and sometimes as a problem solving modality in focal liver lesions. Angiography is performed mainly for therapeutic interventions and for preoperative embolisation of the tumour to reduce bleeding during surgery. Inoperable HCCs, vascular metastases and symptomatic hemangiomas can be well treated by various percutaneous and angiographic interventional techniques.