Liver transplantation and multivisceral transplantation in the management of patients with advanced neuroendocrine tumours

Figure 1 Multimodality imaging in a patient with neuroendocrine liver metastases considered for transplantation. A: Magnetic resonance imaging of the liver in a patient with hepatic metastases from a small bowel neuroendocrine tumour. This patient underwent resection of the primary tumour, and then a left hepatectomy. Following post-hepatectomy lanreotide, peptide receptor radiotherapy and also selective internal radiotherapy for recurrent hepatic metastases, this patient was considered for orthotopic liver transplantation. There was no extra-hepatic disease on conventional cross-sectional imaging. B: ⁶⁸Ga-DOTATATE PET/CT in the same patient. Multiple foci of increased avidity are demonstrated within the liver that were not appreciated on magnetic resonance imaging. C: Radiotracer uptake corresponding to one of multiple bone metastases. According to standard criteria, these would exclude this patient from orthotopic liver transplantation.