Extrahepatic bile duct carcinoma: US characteristics and accuracy in demonstration of tumors.

Robledo, Ricardo; Muro, Avertano; Prieto, Mireya

doi:10.1148/radiology.198.3.8628885

Cited by 74 publications

(41 citation statements)

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“…In a larger study, duplex US was 93% sensitive and 99% specific for detecting portal vein involvement [86] . As the sensitivity and specificity of US are operator-dependent, most patients with suspected CC undergo further imaging modalities to confirm and stage suspected tumors [87] . The sensitivity of US improves significantly in the presence of elevated serum tumor marker Ca 19-9 [80] .…”

Section: Abdominal Ultrasound (Us)mentioning

confidence: 99%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

254

190

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Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic predisposition and congenital abnormalities of the biliary tree. While the incidence of intra-hepatic CC is increasing, the incidence of extra-hepatic CC is trending down. The only curative treatment for CC is surgical resection with negative margins. Liver transplantation has been proposed only for selected patients with hilar CC that cannot be resected who have no metastatic disease after a period of neoadjuvant chemo-radiation therapy. Magnetic resonance imaging/ magnetic resonance cholangiopancreatography, positron emission tomography scan, endoscopic ultrasound and computed tomography scans are the most frequently used modalities for diagnosis and tumor staging. Adjuvant therapy, palliative chemotherapy and radiotherapy have been relatively ineffective for inoperable CC. For most of these patients biliary stenting provides effective palliation. Photodynamic therapy is an emerging palliative treatment that seems to provide pain relief, improve biliary patency and increase survival. The clinical utility of other emerging therapies such as transarterial chemoembolization, hepatic arterial chemoinfusion and high intensity intraductal ultrasound needs further study.

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Section: Abdominal Ultrasound (Us)mentioning

confidence: 99%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

254

190

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show abstract

“…In this series ultrasonography demonstrated ductal obstruction in 89%, and the sensitivity for localizing the site of obstruction was 94% [10] . The sensitivity and specificity of ultrasonography depends on tumor localization, the quality of the equipment and the experience of the investigator [11] . Ultrasound findings are limited in patients with liver cirrhosis and primary sclerosing cholangitis due to a lack of visible dilated bile ducts.…”

Section: Ultrasonographymentioning

confidence: 99%

Diagnostic approaches for cholangiocarcinoma

Weber

Schmid²,

Prinz³

2008

WJG

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Cholangiocarcinomas arise from the epithelial cells of the bile ducts and are associated with poor prognosis. Despite new diagnostic approaches, the definite diagnosis of this malignancy continues to be challenging. Cholangiocarcinomas often grow longitudinally along the bile duct rather than in a radial direction. Thus, large tumor masses are frequently absent and imaging techniques, including ultrasound, CT, and MRI have only limited sensitivity. Tissue collection during endoscopic (ERCP) and/or percutaneous transhepatic (PTC) procedures are usually used to confirm a definitive diagnosis of cholangiocarcinoma. However, forceps biopsy and brush cytology provide positive results for malignancy in about only 50% of patients. Percutaneous and peroral cholangioscopy using fiber-optic techniques were therefore developed for direct visualization of the biliary tree, yielding additional information about endoscopic appearance and tumor extension, as well as a guided biopsy acquistion. Finally, endoscopic ultrasonography (EUS) complements endoscopic and percutaneous approaches and may provide a tissue diagnosis of tumors in the biliary region through fineneedle aspiration. In the future, new techniques allowing for early detection, including molecular m a r ke r s , s h o u l d b e d e ve l o p e d t o i m p rove t h e diagnostic sensitivity in this increasing tumor entity.

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“…Most hilar and extrahepatic cholangiocarcinomas are infiltrative, causing a focal stricture of the bile duct, whereas papillary carcinoma is occasionally found in the form of an intraductal polypoid mass (13,32,95,116). By thin-section computed tomography, the tumor tissue of the infiltrative type can be detected as an ill-defined focal wall thickening, usually with early or late enhancement or both (13,33).…”

Section: Imaging Findingsmentioning

confidence: 99%

“…By thin-section computed tomography, the tumor tissue of the infiltrative type can be detected as an ill-defined focal wall thickening, usually with early or late enhancement or both (13,33). By ultrasonography, the tumor can appear as a mural thickening or as an encircling mass along the bile duct wall (95). However, in many cases, the infiltrating tumor is frequently seen by either ultrasonography or computed tomography as nonunion of the dilated right and left hepatic ducts without an identifiable mass (13,104).…”

Section: Imaging Findingsmentioning

confidence: 99%

Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

et al. 2004

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Despite a gradual decrease in prevalence, clonorchiasis is still prevalent in East Asia. A large and compelling body of evidence links clonorchiasis and cholangiocarcinoma, although the mechanisms involved are not completely understood. Clonorchiasis induces biliary epithelial hyperplasia and metaplasia, and this could facilitate at least one stage of the carcinogenesis, which is promoting effect. In areas of endemic infection, more clonorchiasis cases are now diagnosed incidentally during radiological examinations such as cholangiography, ultrasonography, and computed tomography. Radiological findings are regarded as pathognomonic for clonorchiasis since they reflect the unique pathological changes of this disorder. These radiological examinations currently play important roles in the diagnosis, staging, and decision-making process involved in the treatment of cholangiocarcinoma. The morphological features and radiological findings of clonorchiasis-associated cholangiocarcinoma are essentially combinations of the findings for the two diseases. The morphological features of clonorchiasis- associated cholangiocarcinoma, observed in radiological examinations, do not differ from those of the usual cholangiocarcinoma. In patients diagnosed with or suspected to have clonorchiasis, radiological findings should be carefully scrutinized for occult cholangiocarcinoma

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Extrahepatic bile duct carcinoma: US characteristics and accuracy in demonstration of tumors.

Cited by 74 publications

References 0 publications

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Diagnostic approaches for cholangiocarcinoma

Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

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