Differentiation of benign and malignant hilar bile duct stenosis

Yang, Zhiying; Tan, Haidong; Shao, Chen; Liu, Liguo; Si, Shuang; Xu, Li; Sun, Yongliang

doi:10.1016/j.jss.2016.03.002

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…Bile duct drainage is often the first-line treatment in the management of such patients, but physicians should rapidly consider whether chemotherapy and/or biliopancreatic surgical resection are appropriate [2][3][4][5]. Prior to such treatment, cholangiocarcinoma cytopathological characterization must be determined, because 5 %-25 % of indeterminate bile duct stenoses are benign and 3 %-7 % of patients who undergo surgery for a suspected malignant bile duct stenosis have a benign disease [1,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Multicenter randomized trial comparing diagnostic sensitivity and cellular abundance with aggressive versus standard biliary brushing for bile duct stenosis without mass syndrome

Karsenti¹,

Privat

Charissoux³

et al. 2023

Endoscopy

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Background and aims Diagnosis of cholangiocarcinoma in case of biliary stricture without mass syndrome is obtained by biliary brushing with approximately 50% sensitivity. We performed a multicenter randomized crossover trial comparing the aggressive Infinity brush with the standard RX Cytology Brush. The aims were sensitivity for cholangiocarcinoma diagnosis and cellularity abundance. Methods 51 patients were included. Biliary brushing was performed consecutively with each brush, in a randomized order. Cytological material was studied in a blinded manner concerning the brush. The primary endpoint was sensitivity for cholangiocarcinoma diagnosis, and the secondary endpoint was the abundance of the cellularity obtained with each brush. Cellularity was quantified, in order to determine if one brush strongly outperformed the other. Results Final diagnosis was cholangiocarcinoma (n = 43, 84%), benign (n = 7, 14%) and indeterminate (1 case). Sensitivity for cholangiocarcinoma was 34/43 (79%) for the Infinity brush versus 29/43 (67%) for the RX Cytology Brush (p = 0.096). Cellularity was rich in 31/51 (61%) cases with the Infinity brush and in 10/51 (20%) cases with the RX Cytology Brush (p < 0.001). In terms of cellularity quantification, the Infinity brush strongly outperformed the RX Cytology Brush in 28/51 cases (51%), while the RX Cytology Brush strongly outperformed the Infinity brush in 4/51 cases (8%) (p < 0.001). <b>Conclusions</b> This randomized crossover trial shows that the Infinity brush is not significantly more effective than the RX Cytology Brush for biliary stenosis without mass syndrome in terms of sensitivity for cholangiocarcinoma but does allow significantly higher cellularity abundance. <b>ClinicalTrials.gov ID: NCT04251013</b>

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Section: Introductionmentioning

confidence: 99%

Multicenter randomized trial comparing diagnostic sensitivity and cellular abundance with aggressive versus standard biliary brushing for bile duct stenosis without mass syndrome

Karsenti¹,

Privat

Charissoux³

et al. 2023

Endoscopy

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show abstract

“…Occasionally, a benign stricture manifests as a focal area of wall thickening and mimics a malignant lesion ( 7 , 8 ), and surgical resection may be performed. However, unnecessary surgery may delay appropriate treatment and lead to deterioration of patient condition ( 9 ). In clinical practice, early and accurate preoperative diagnosis of the cause of a BS is important to increase the likelihood of complete resection and to avoid unnecessary surgery.…”

Section: Introductionmentioning

confidence: 99%

MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

Wang

Zhang

et al. 2021

Front. Oncol.

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ObjectiveTo determine whether contrast-enhanced computed tomography (CT) can promote the identification of malignant and benign distal biliary strictures (DBSs) compared to the use of magnetic resonance cholangiopancreatography (MRCP) alone and to identify imaging findings of malignant DBSs.Materials and MethodsA total of 168 consecutive patients with confirmed DBSs were reviewed. MRCP alone and MRCP combined with CT images were blindly analyzed by two radiologists (e.g., stricture pattern, margins), and malignant or benign DBSs were identified based on surgical findings, endoscopy findings, or follow-up. The diagnostic accuracy of the two reviewers using MRCP alone and MRCP combined with CT were evaluated. MRCP and CT features of malignant and benign DBSs were compared using multiple logistic regression analysis to identify independent malignant risk factors.ResultsMRCP combined with CT examination could improve the diagnostic accuracy, which increased from 70.2% to 81.5% in Doctor A and from 85.1% to 89.3% in Doctor B. The multiple logistic regression model revealed that stricture length [odds ratio (OR) 1.070, P=0.016], angle of the DBS (OR 1.061, P<0.001), double duct sign (OR 4.312, P=0.003) and low density in the arterial phase (OR 0.319, P=0.018) were associated with malignant DBS. A scoring model incorporating these four factors was established; at a threshold value of 1.75, and the sensitivity and specificity for the detection of malignant DBSs were 73.5 and 85.9%, respectively.ConclusionsCompared to the use of MRCP alone, MRCP combined with contrast-enhanced CT can improve the accuracy of DBS diagnosis. The scoring model accurately predicts malignant DBSs and helps make treatment decisions.

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Microwave ablation technique (MWA) for cancer treatment: Simulation of single Slot MCA for different slot position

Razib

Hossain

2016

2016 International Conference on Medical Engineering, Health Informatics and Technology (MediTec)

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Differentiation of benign and malignant hilar bile duct stenosis

Cited by 3 publications

References 29 publications

Multicenter randomized trial comparing diagnostic sensitivity and cellular abundance with aggressive versus standard biliary brushing for bile duct stenosis without mass syndrome

Multicenter randomized trial comparing diagnostic sensitivity and cellular abundance with aggressive versus standard biliary brushing for bile duct stenosis without mass syndrome

MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

Microwave ablation technique (MWA) for cancer treatment: Simulation of single Slot MCA for different slot position

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