Several studies have demonstrated the accuracy of CT hepatic angiography (CTHA) in detection of HCC. Our study aims to evaluate the role of CTHA and liver biopsy in this patient group. Methods: A retrospective study of 78 consecutive patients with a first diagnosis of HCC at our institution between January 2008 and May 2014 was performed. Of these, 48 met the inclusion criteria of not meeting European association for study of liver (EASL) guidelines for HCC (Defined as absence of arterial enhancement and portal venous washout). Baseline demographic data was recorded including tumor characteristics,

serum alpha fetoprotein, details click here of radiologic imaging, treatment regime and tumor response using modified response evaluation criteria in solid tumors (mRECIST). Results: There were 48 patients with HCC that had atypical radiological features not fulfilling EASL criteria at initial presentation. The majority were male: 89 % (43/48) with an average age of 66 years (Range 49–84 years). Ultrasound guided biopsy was employed in 45% of cases (22/48), CT hepatic arteriography (CTHA) in 29% (10/48) and conventional angiography in 6% (3/48). No further investigation was performed in 12.5% (6/48) due to poor functional

status and in 14.6% (7/48) treatment was initiated based on enlarging mass and consensus opinion at HCC multidisciplinary meeting. The average diameter of lesions diagnosed using CTHA MCE was smaller compared with biopsy GSK458 solubility dmso (29 mm (Range: 13–56 mm) vs 56 mm (Range: 13–190 mm) with p = 0.005). The average time to diagnosis of HCC from initial imaging was not significantly different between biopsy

and CTHA : 7 weeks vs 15 weeks (p = 0.13) Of the patients that underwent biopsy for diagnosis 68% (15/22) were treated with complete or partial tumor response seen in 73% (11/15). Of those that underwent CTHA for diagnosis 100% (10/10) were treated achieving a complete or partial tumor response. There was no statistical significance in tumor response rate between the CTHA group compared with biopsy group. Conclusion: CT hepatic angiography provides an alternative to biopsy in the diagnosis of suspected hepatocellular with atypical imaging without the risk of potential tumor seeding associated with biopsy. Smaller lesions can be diagnosed using CTHA and with no adverse difference in time to diagnosis or treatment outcomes. D MANGIRA,1 A CHUANG,2 J CHEN,3 R WOODMAN,4 A WIGG5 1South Australian Liver Transplant Unit, Flinders Drive Bedford Park, Adelaide, 2Flinders University, Bedford Park, SA, Australia Background and Aims: Harmful alcohol drinking impairs long-term survival post liver transplantation (LT). The aim of this study was to investigate the prevalence of harmful relapse to alcohol following LT for alcoholic liver disease (ALD) and to investigate for variables associated with armful relapse, in an Australian LT population.