The 5-year survival rate for untreated, symptomatic HCC is < 5%. In contrast, the 5- year survival rate in patients with cirrhosis following transplantation of small (2 cm) HCC is 80%. The detection of small HCC is clearly critical to patient outcome. Although many CT and magnetic resonance (MR)

imaging studies have reported high diagnostic accuracy for HCC and Dysplastic Nodules (DN) in patients with cirrhosis, most of these have been limited by study TSA HDAC supplier design, incomplete pathologic correlation and suboptimal imaging techniques. Correlation between explant pathology and pretransplant radiology is of prime importance- among other factors- to choose the suitable line of treatment for liver nodules in cirrhotic patients including follow up, locoregional therapy, liver transplantation or paliative treatment. Methods: 100 patients who underwent liver transplantation at our institution between 2002 and 2013 for the presence of HCC were retrospectively reviewed. Liver transplantation was performed ACP-196 cost either as primary treatment or following bridging locoregional treatment. HCC was radiologically diagnosed. Radiological diagnosis was performed using one or two contrast enhanced dynamic imaging studies

including Multidetector computed tomography (MDCT) and MRI. Pathological examination was made using whole liver explant examination by senior pathologists who have experience in liver pathology. Pathologists had knowledge about the pretransplant radiological findings. Radiological and pathological correlation

was made between explant pathology and radiological findings. Correlation was made on per nodule level including size, location and nature. Results: A total 230 nodules were identified in explant pathology from 100 liver transplant patients. Overall; 208 nodules were radiologically identified before transplant (90.4%), while pretransplant imaging modalities failed to show 22 nodules (9.6%). Out of the missed nodules 10 HCC lesions and 12 dysplastic nodules (4.3% and 5.2 % out of all lesions respectively) were pathologically identified. Out of the identified nodules 59 were misinterpreted.114 nodules were found to be more than or find more equal to 2cm in maximum dimensions by pathology (group 1)compared to 67 between 1and 2 cm (group2) and 49 less than 1 cm (group 3). percentage of the missed or misinterpreted nodules was significantly less in first group as compared to the other two group, (p=0.000) Conclusion: pretransplant imaging modalities are very relaible in diagnosis of cirrhotic liver nodules specially in smalll lesions Disclosures: Hussien Elsiesy – Speaking and Teaching: ROCHE, BMS, JSK The following people have nothing to disclose: Mohamed R. Abdelfattah, Hadeel Al-mana, Mohamed Neimatallah, Mohammed Al-sebayel, Dieter C.