ACR Appropriateness Criteria® Suspected Liver Metastases

Harmeet Kaur*, Nicole M. Hindman, Waddah B. Al-Refaie, Hina Arif-Tiwari, Brooks D. Cash, Victoria Chernyak, James Farrell, Joseph R. Grajo, Jeanne M. Horowitz, Michelle M. McNamara, Richard B. Noto, Aliya Qayyum, Tasneem Lalani, Ihab R. Kamel, Expert Panel on Gastrointestinal Imaging:

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Liver metastases are the most common malignant liver tumors. The accurate and early detection and characterization of liver lesions is the key to successful treatment strategies. Increasingly, surgical resection in combination with chemotherapy is effective in significantly improving survival if all metastases are successfully resected. MRI and multiphase CT are the primary imaging modalities in the assessment of liver metastasis, with the relative preference toward multiphase CT or MRI depending upon the clinical setting (ie, surveillance or presurgical planning). The optimization of imaging parameters is a vital factor in the success of either modality. PET/CT, intraoperative ultrasound are used to supplement CT and MRI. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)S314-S325
JournalJournal of the American College of Radiology
Issue number5
StatePublished - May 2017


  • AUC
  • Appropriate Use Criteria
  • Appropriateness Criteria
  • MRI
  • PET/CT
  • liver metastasis imaging
  • liver metastasis surveillance
  • liver presurgical staging
  • multidetector CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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