The Role of the Multiparametric MRI LiverMultiScan(TM) in the Quantitative Assessment of the Liver and Its Predicted Clinical Applications in Patients Undergoing Major Hepatic Resection for Colorectal Liver Metastasis

SIMPLE SUMMARY: This narrative review summarises the current limited literature relating to multiparametric magnetic resonance imaging software (called LiverMultiScan(TM)) used for the purpose of analysing liver tissue in a non-invasive approach to assess liver health. Liver health is of particular importance when considering patients with liver malignancy planned for a major liver resection. The aim of this review is to consider the current evidence for its use in the setting of chronic liver disease, liver malignancy, and perioperative planning, and to examine the future applications of such software and the hurdles it must surpass to improve patient selection and outcomes in liver surgery. ABSTRACT: Liver biopsy remains the gold standard for the histological assessment of the liver. With clear disadvantages and the rise in the incidences of liver disease, the role of neoadjuvant chemotherapy in colorectal liver metastasis (CRLM) and an explosion of surgical management options available, non-invasive serological and imaging markers of liver histopathology have never been more pertinent in order to assess liver health and stratify patients considered for surgical intervention. Liver MRI is a leading modality in the assessment of hepatic malignancy. Recent technological advancements in multiparametric MRI software such as the LiverMultiScan(TM) offers an attractive non-invasive assay of anatomy and histopathology in the pre-operative setting, especially in the context of CRLM. This narrative review examines the evidence for the LiverMultiScan(TM) in the assessment of hepatic fibrosis, steatosis/steatohepatitis, and potential applications for chemotherapy-associated hepatic changes. We postulate its future role and the hurdles it must surpass in order to be implemented in the pre-operative management of patients undergoing hepatic resection for colorectal liver metastasis. Such a role likely extends to other hepatic malignancies planned for resection.