Advanced imaging of colorectal cancer liver metastases: Impact on treatment with surgery and local ablation

Colorectal cancer spread to distant organs is common, occurring in up to one-fifth of patients at diagnosis, most commonly the liver.  Unlike some other tumours, spread to the liver can be managed with curative intent with surgery or image-guided therapies known as ablation. Traditionally, doctors trained to interpret medical imaging (radiologists) will visually plan or assess how successful a treatment has been. This thesis aimed to investigate how we can improve on radiologist visual assessment to better guide management of patients with colorectal cancer spread to the liver. This research found that by analysing medical images on MRI commonly used to plan liver surgery, we could better identify patients that may recur compared to traditional clinical parameters or radiologist assessment.  We were also able to demonstrate that using computer software to assess whether a liver ablation had been successful is potentially advantageous compared to expert radiologist interpretation.