Regardless of which technique is used, the accurate assessment of number and location of hepatic metastases is a crucial issue for adequate treatment planning and successfully therapy [9]. At initial diagnosis, about 25–30% of patients are not resectable due to the extent of hepatic disease or a small future liver remnant (FLR). Computed tomography is routinely used as a method for preoperative calculation of the remnant liver. With a normal parenchyma, FLR should range between 20% and 30% of estimated total liver volume [10], with a minimum cut-off set at 20%, below which risk of liver failure [11], infections, and liver mortality is significantly increased. Whereas, when an underlying liver disease preexists (steatosis, cholestasis, fibrosis, cirrhosis, or chemotherapy), FLR should be greater than 30– 40% [12]. Liver toxicity due to chemotherapic agents, namely chemotherapy­induced liver injury (CALI), is common in patients who received prolonged treatment for colorectal liver metastases. In this setting, multimodality treatment for colorectal liver metastases suggested a minimal FLR ratio of at least 40% [13]or higher [14] in patients heavily pretreated with chemotherapy. The two typical histological patterns are represented by the sinusoidal injury (sinusoidal obstruction syndrome) in oxaliplatin-based regimens, and chemotherapy-associated steatohep­atitis (CASH) secondary to the use of irinotecan [15]. More than six cycles of oxaliplatin need a longer time interval before major hepatectomy, even though accountability for PHLF still remains a matter of debate [16]. Whereas, use of irinotecan has been demonstrated to be associated with an increased risk of peri-operative mortality [15].