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Abdominal Radiology

, Volume 43, Issue 1, pp 193–202 | Cite as

LI-RADS and transplantation for hepatocellular carcinoma

  • An Tang
  • Kathryn J. Fowler
  • Victoria Chernyak
  • William C. Chapman
  • Claude B. Sirlin
Invited article

Abstract

Patients with hepatocellular carcinoma (HCC) may be eligible for liver transplantation. Liver transplant candidates with HCC compete for the same deceased donor organs as those without HCC. These scarce organs must be allocated fairly and justly to those who will benefit most. Unlike most other cancers, HCC is often diagnosed noninvasively by imaging without biopsy confirmation. Therefore, radiologists play an important role in diagnosing definite HCC (i.e., LR-5 category) that counts toward staging and determination of liver transplant eligibility. This review explains the conversion of LI-RADS observation categories to organ procurement and transplantation network classes, illustrates the radiologic T-staging systems, reviews selection criteria for liver transplant eligibility, and discusses prioritization of liver transplant candidates with HCC. In addition, this review summarizes imaging requirements, including contrast agents accepted, minimum specifications for dynamic CT or MRI of the liver, and modalities accepted for assessment of extrahepatic spread or metastatic disease in liver transplant candidates with HCC.

Keywords

Review article Hepatocellular carcinoma Transplantation Staging Eligibility Prioritization 

Abbreviations

AASLD

American Association for the Study of Liver Diseases

ALTS

American Liver Tumor Study Group

BCLC

Barcelona Clinic Liver Cancer

HCC

Hepatocellular Carcinoma

LI-RADS

Liver Imaging Reporting and Data System

UNOS

United Network for Organ Sharing

OPTN

Organ Procurement and Transplantation Network

Notes

Acknowledgements

This work was supported by (1) the Fonds de recherche du Québec—Santé (Career Award #26993), and (2) New Researcher Startup Grant from the Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM) to An Tang.

Compliance with ethical standards

Disclosures

An Tang: Advisory Board of Imagia Cybernetics. Kathryn J. Fowler and Victoria Chernyak have nothing to disclose. William Chapman: Scientific Advisory Board of Novartis Pharmaceutical. Founder of Pathfinder Therapeutics. Claude B. Sirlin: Industry research grants Bayer, Guerbet, Siemens, GE, Philips, Supersonic, Arterys. Consulting and service agreements Alexion, AstraZeneca, Bioclinica, BMS, Bracco, Celgene, Fibrogen, Galmed, Genentech, Genzyme, Gilead, Icon, Intercept, Isis, Janssen, NuSirt, Perspectum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, Virtual Scopics.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Radiology, Radio-oncology and Nuclear MedicineUniversity of Montreal and CRCHUMMontréalCanada
  2. 2.Department of RadiologyWashington UniversitySt. LouisUSA
  3. 3.Department of RadiologyMontefiore Medical CenterBronxUSA
  4. 4.Department of SurgeryWashington UniversitySt. LouisUSA
  5. 5.Liver Imaging Group, Department of RadiologyUniversity of California San DiegoSan DiegoUSA

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