Outline a standard imaging workup for a suspected liver mass.

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The imaging workup begins with ultrasound as the initial screen because it’s quick, accessible, and can detect a lesion and assess basic features. If a lesion is seen or the ultrasound is inconclusive, proceed with cross-sectional imaging using a multiphasic contrast-enhanced CT or an MRI with a liver protocol. These dynamic studies capture how a lesion enhances across arterial, portal venous, and delayed phases, which helps distinguish common liver lesions such as hepatocellular carcinoma, hemangioma, focal nodular hyperplasia, and metastases. Using liver-specific contrast agents can improve detection and characterization, especially for small lesions or in a cirrhotic liver. If imaging remains indeterminate, or if histology would change management, an image-guided biopsy is considered.

CT without contrast or MRI without dynamic sequences lack the enhancement information needed to differentiate lesions, so they aren’t appropriate as the first step.