Radiology in Transplant

Abstract

There have been several advances in liver imaging that have affected liver transplantation, with the adoption of new policies for hepatocellular carcinoma (HCC) and exploration of new imaging techniques for assessment of liver lesions, steatosis, and fibrosis. The implementation of the Organ Procurement and Transplant Network (OPTN) criteria for non-invasive diagnosis of HCC impacted organ allocation, and the proposed LI-RADS (Liver Imaging Reporting and Data System) recommendations should enable standardization of the reporting of liver lesion characteristics. New methods to enhance existing magnetic resonance imaging (MRI) or computed tomography (CT) techniques have improved correlation with tumor histology and with prognosis of the disease after locoregional treatment. The use of contrast-enhanced ultrasound may also be a promising cost-efficient method for early detection of HCC. This review also comments on the use of CT and MRI for evaluating living donor candidates, and the use of elasticity imaging with MRI or ultrasound for graft fibrosis after liver transplantation.