Developments in ultrasound, CT scan, and MR imaging have increased our ability to detect and characterize focal liver lesions. Advances in the medical and surgical treatment of secondary liver tumors have continued to challenge these advances in radiology. A successful outcome depends on knowledge of the size and location of the tumor burden, and accurate radiologic assessment is crucial to identify those subgroups who may benefit from surgery and to prevent unnecessary radical surgery in those likely to gain only a short-term benefit.