Tests to diagnose Liver Metastases

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Clinical history. Assessment of the patient's clinical history.
Blood test. Includes parameters to assess liver function (AST, ALT, GOT, GPT, AP, Bilirubin); coagulation (another liver function) using Quick’s Index, PTT aPTT, INR, as well as protein synthesis and tumour markers specific for different cancer types (CEA, which is more specific for digestive tumours such as colon and Ca 19.9 from other types of cancer such as pancreas and bile duct).
Extension study. These are the different tests performed to find out which parts of the body are affected by cancer: Computed Axial Tomography (CAT); Magnetic Resonance Imaging (MRI); Positron Emission Tomography (PET).
Computed tomography (CT or scan). This is the main test for an initial diagnosis of liver metastases. This test provides a very detailed initial evaluation of the number of existing lesions in the liver, their location and their extension to structures essential for liver functioning (e.g. portal vein, suprahepatic vein and biliary tree).
Nuclear Magnétic Resonance (NMR). Although not done systematically, this test is sometimes needed to complete the findings obtained from a CAT.
Positron emission tomography-CT (PET-CT). Tumour radiological-metabolic evaluation. This is a complex test that sweeps the entire body to find metastases in other parts of the body, as well as to differentiate between a malignant and a benign lesion, if there are doubts about whether or not a lesion is a metastasis.

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