Imaging features and management of focal liver lesions

Core Tip

Core Tip: The incidence of incidentally detected focal liver lesions (FLL) has risen significantly due to increased radiological imaging use. While benign FLLs are more common, even in patients with primary malignancy, accurate diagnosis is clinically significant. Non-invasive evaluation, such as ultrasound, computed tomography, and magnetic resonance imaging (MRI), is common in clinical practice. MRI, particularly with hepatobiliary-specific contrast agents, has enhanced FLL characterization, reducing unnecessary biopsies. Guidelines from the American College of Radiology, American College of Gastroenterology, and American Association for the Study of Liver Diseases offer evidence-based recommendations for optimal imaging and management. This article provides a comprehensive review of FLL, covering imaging methods, current techniques and modalities, innovations in imaging, contrast agents, features of nonmetastatic benign and malignant FLLs, and current management recommendations.