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Focal liver lesions

Key sources
The following summarized guidelines for the evaluation and management of focal liver lesions are prepared by our editorial team based on guidelines from the European Association for the Study of the Liver (EASL 2022; 2016), the European Federation of Societies for Ultrasound (EFSU 2020), the American College of Radiology (ACR 2020), the American College of Gastroenterology (ACG 2014), and the Spanish Working Group on Inherited Kidney Diseases (SWG-IKD 2014).
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Guidelines

1.Diagnostic investigations

Contrast-enhanced ultrasound
As per ACR 2020 guidelines:
Obtain contrast-enhanced abdominal ultrasound of an indeterminate > 1 cm liver lesion on initial ultrasound in patients with a normal liver with no suspicion or evidence of extrahepatic malignancy or underlying liver disease.
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Obtain contrast-enhanced abdominal ultrasound of an incidental liver lesion > 1 cm on initial ultrasound, non-contrast or single-phase CT, or non-contrast MRI in patients with known chronic liver disease.
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  • Cross-sectional imaging

2.Specific circumstances

Patients with simple hepatic cysts, evaluation, EASL: obtain ultrasound as the first-line imaging for the diagnosis of hepatic cysts.
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More topics in this section

  • Patients with simple hepatic cysts (management)

  • Patients with simple hepatic cysts (surveillance)

  • Patients with polycystic liver disease (evaluation)

  • Patients with polycystic liver disease (management)

  • Patients with hepatic hemangioma

  • Patients with focal nodular hyperplasia

  • Patients with nodular regenerative hyperplasia

  • Patients with hepatic mucinous cystic neoplasms

  • Patients with biliary mucinous cystic neoplasms

  • Patients with hepatocellular adenoma

  • Patients with HCC

  • Patients with cholangiocarcinoma

  • Patients with hydatid cysts