Availability of long sought accurate, non-invasive biomarkers for vascular tumour involvement (ΜVI) and response to treatment will have a measurable marked impact for the management of the individual patient with hepatocellular carcinoma (HCC) and the mobilization of health care resources. The ability to predict ΜVI will allow candidates with good outcomes to be spared liver graft surgery. The ability to rule out ΜVI will allow patients to benefit from liver transplantation while they would have been excluded according to current, less accurate rules. It is expected that about 25% of current candidates for liver transplantation for HCC could be accurately re-allocated to an appropriate treatment strategy without waiting for obvious progression on the waiting list. Furthermore, availability of this novel preoperative will allow for the evaluation of neo-adjuvant antineoplastic therapy after stratification for MVI.