Evaluation of benign and malignant liver lesions on MRI and PET scans, systematic approach

Learning Objectives 1. How to approach a liver lesion by MRI and nuclear medicine scans. 2. Overview of the most important MRI sequences in evaluating liver lesions. 3. Overview of nuclear medicine scans ( Octreotide, Ga 68, Liver spleen scan, red blood cells) of variable liver lesions. 4. Overview of variable normal liver appearances on FDG PET scan including OSEM reconstructing algorithm.

With the PET/MRI scanners now in the market, the nuclear medicine physician as a PET scan reader should be familiar with the basic approach to evaluate liver lesions by MRI as well as PET. The PET/MRI scan reader should be familiar with different sequences and protocols of MRI for better evaluation of any liver lesion. In this educational exhibit we describe a practical and systematic approach on how to evaluate a liver lesion by MRI and PET, what sequences are needed and how to differentiate among different liver lesions, including benign versus malignant lesions. Illustrative examples will be provided, including classic and rare HCC appearance, Fibrolamellar HCC, adenoma, hemangioma, FNH, neuroendocrine tumors, fatty infiltrates, perivascular fatty infiltrates, metastasis, false negative PET scans, Octreotide scan, Ga 68 PET scan.