This paper presents a fully automated method for detection and segmentation of liver metastases in serial computed tomography (CT) examinations. Our method uses a given two-dimensional baseline segmentation mask for identifying the lesion location in the follow-up CT and locating surrounding tissues, using nonrigid image registration and template matching, in order to reduce the search area for segmentation. Adaptive region growing and mean-shift clustering are used to obtain the lesion segmentation. Our database contains 127 cases from the CT abdomen unit at Sheba Medical Center. Development of the methodology was conducted using 22 of the cases, and testing was conducted on the remaining 105 cases. Results show that 94 of the 105 lesions were detected, for an overall matching rate of 90% making the correct RECIST 1.1 assessment in 88% of the cases. The average Dice index was , the average sensitivity was , and the positive predictive value was . In 92% of the rated cases, the results were classified by the radiologists as acceptable or better. The segmentation performance, matching rate, and RECIST assessment results hence appear promising.