Preoperative Imaging of Colorectal Liver Metastases: What the Radiologist and the MDT Need to Know

The management of patients with colorectal liver metastases (CRLM) has transformed over the past two decades. Advances in surgical techniques, systemic therapies and local treatments have resulted in a paradigm shift. Disease that would once have been considered terminal is now frequently treated aggressively with both a disease-free and overall survival benefit. In line with the expanding range of treatment options, there has been an increase in the volume and complexity of imaging required in the management of these patients to ensure optimal patient selection and outcome. The radiologist plays a pivotal role in interpreting these studies, conveying the relevant information and informing the discussion at multidisciplinary team meetings (MDM). The purpose of this review is to provide an update for radiologists on the current surgical management of patients with CRLM highlighting specific imaging information that is required by the MDT when assessing resectability and/or the need for additional liver-directed therapies.