Liver imaging can be performed with sonography, computed tomography (CT) and magnetic resonance imaging (MRI). Ultrasound is, caused by the easy access, still the first-line imaging method of choice; CT and MRI are applied whenever ultrasound imaging yields vague results. Indications are the characterization of metastases and primary liver tumors e.g., benign lesions such as focal nodular hyperplasia (FNH), adenoma, hemangioma and malignant lesions (cancer) such as hepatocellular carcinomas (HCC). The decision, which medical imaging modality is more suitable, MRI or CT, is dependent on the different factors. CT is less costly and more widely available; modern multislice scanners provide high spatial resolution and short scan times but has the disadvantage of radiation exposure.
With the introduction of high performance MR systems and advanced sequences the image quality of MRI for the liver has gained substantially. Fast spin echo or single shot techniques, often combined with fat suppression, are the most common T2 weighted sequences used in liver MRI procedures. Spoiled gradient echo sequences are used as ideal T1 weighted sequences for evaluating of the liver. The repetition time (TR) can be sufficiently long to acquire enough sections covering the entire liver in one pass, and to provide good signal to noise. The TE should be the shortest in phase echo time (TE), which provides strong T1 weighting, minimizes magnetic susceptibility effects, and permits acquisition within one breath hold to cover the whole liver. A flip angle of 80° provides good T1 weighting and less of power deposition and tissue saturation than a larger flip angle that would provide comparable T1 weighting.
Liver MRI is very dependent on the administration of contrast agents, especially when detection and characterization of focal lesions are the issues. Liver MRI combined with MRCP is useful to evaluate patients with hepatic and biliary disease.
Gadolinium chelates are typical non-specific extracellular agents diffusing rapidly to the extravascular space of tissues being cleared by glomerular filtration at the kidney. These characteristics are somewhat problematic when a large organ with a huge interstitial space like the liver is imaged. These agents provide a small temporal imaging window (seconds), after which they begin to diffuse to the interstitial space not only of healthy liver cells but also of lesions, reducing the contrast gradient necessary for easy lesion detection. Dynamic MRI with multiple phases after i.v. contrast media (Gd chelates), with arterial, portal and late phase images (similar to CT) provides additional information.
An additional advantage of MRI is the availability of liver-specific contrast agents (see also Hepatobiliary Contrast Agents). Gd-EOB-DTPA (gadoxetate disodium, Gadolinium ethoxybenzyl dimeglumine, EOVIST Injection, brand name in other countries is Primovist) is a gadolinium-based MRI contrast agent approved by the FDA for the detection and characterization of known or suspected focal liver lesions.
Gd-EOB-DTPA provides dynamic phases after intravenous injection, similarly to non-specific gadolinium chelates, and distributes into the hepatocytes and bile ducts during the hepatobiliary phase. It has up to 50% hepatobiliary excretion in the normal liver.
Since ferumoxides are not eliminated by the kidney, they possess long plasmatic half-lives, allowing circulation for several minutes in the vascular space. The uptake process is dependent on the total size of the particle being quicker for larger particles with a size of the range of 150 nm (called superparamagnetic iron oxide). The smaller ones, possessing a total particle size in the order of 30 nm, are called ultrasmall superparamagnetic iron oxide particles and they suffer a slower uptake by RES cells. Intracellular contrast agents used in liver MRI are primarily targeted to the normal liver parenchyma and not to pathological cells. Currently, iron oxide based MRI contrast agents are not marketed.
Beyond contrast enhanced MRI, the detection of fatty liver disease and iron overload has clinical significance due to the potential for evolution into cirrhosis and hepatocellular carcinoma. Imaging-based liver fat quantification (see also Dixon) provides noninvasively information about fat metabolism; chemical shift imaging or T2*-weighted imaging allow the quantification of hepatic iron concentration.

See also Abdominal Imaging, Primovistâ„¢, Liver Acquisition with Volume Acquisition (LAVA), T1W High Resolution Isotropic Volume Examination (THRIVE) and Bolus Injection.

For Ultrasound Imaging (USI) see Liver Sonography at Medical-Ultrasound-Imaging.com.

On October 19, 2001, Philips Medical Systems completed an acquisition strategy through its purchase of Marconi Medical Systems.

The History of Marconi Medical Systems
2001 Royal Philips Electronics and Marconi plc announced that Philips has agreed to acquire Marconi Medical Systems for $1.1 billion.
2000 Marconi introduces Infinite Detector Technology for Mx8000 multislice CT scanner, which acquires an unprecedented 16 simultaneous slices with sub-millimeter isotropic accuracy.
1999 At RSNA, Picker International unveils the new Marconi Medical Systems name and corporate vision.
1998 Picker International acquires the Computed Tomography Division of Elscint Ltd, immediately positioning Picker at the forefront of major global CT suppliers.
1986 Picker produces the industry's first 1.0T MR imager.
1981 Picker is sold to General Electric Co. Ltd. of England (GEC). Picker merged with Cambridge Instruments, GEC Medical, and American Optical to form Picker International.
1967 The name changed from Picker X-ray to Picker Corporation. Picker acquired Dunlee.
1946 The Dunlee Corporation started in Chicago by Dunmore Dunk and Zed. J. Atlee to meet demand for quality X-ray tubes and special purpose tubes.
1915 James Picker Company formed in New York City offering sales and service of X-ray equipment, film and accessories.

See also Philips Medical Systems and MRI History.

(MPR) The postprocessing reformatting of a 3D data set into 2D slices of arbitrary thickness at any angle. For a good resolution thin slices, isotropic voxel and overcontiguous slices (overlapping slices) for good signal are advantageous.

Size of smallest spatially resolved regions in an image. It may be anisotropic, e.g. with an asymmetric acquisition matrix or slice thickness, and may be larger than the pixel or voxel.

The smallest distance between two points in the object that can be distinguished as separate details in the image, generally indicated as a length or a number of black and white line pairs per mm (lp/mm).
The specific criterion for resolution to be used, depends on the type of test used (e.g., bar pattern or contrast-detail phantom). As the ability to separate or detect objects depends on their contrast and the noise, and the different MR parameters of objects will affect image contrast differently for different imaging techniques, care must be taken in comparing the results of resolution phantom tests of different machines and no single simple measure of resolution can be specified.
The resolution may be an isotropic one. The resolution may be larger than the size corresponding to the discrete image element (pixel), although it cannot be smaller.