Tumor diagnosis in the adult liver transplant candidate

Hepatic transplantation has emerged as a potentially curative treatment of certain malignant hepatic neoplasms such as hepatocellular carcinoma, bile duct carcinoma, fibrolamellar hepatocellular carcinoma, metastases from neuroendocrine tumors, and epithelioid hemangioendothelioma. In the early years of hepatic transplantation, there was great enthusiasm to cure patients with unresectable hepatobiliary malignancy. This early enthusiasm was tempered by the unfavorable outcome of transplantation in advanced cases of malignancy and the organ-donor shortage. Presently, patients have to be selected with predictable likelihood for long-term survival. Pre-transplantation imaging is indispensable for detection, characterization, staging, and surgical road-mapping before the procedure. The present article focuses on the role of imaging modalities in these different aspects of preoperative assessment.