Improved Diagnostic Yield of Endoscopic Biliary Brush Cytology by Digital Image Analysis

Prospective Evaluation of Advanced Molecular Markers and Imaging Techniques in Patients With Indeterminate Bile Duct Strictures

“…Because of the relative inability of RC and intraductal biopsy to distinguish benign from malignant bile duct strictures, there has been a pursuit for improved cytologic techniques, such as DIA and FISH, and improved imaging studies, including IDUS (7,8,29,30).We have previously studied these new tests independently, and demonstrated that DIA, FISH, and IDUS each improve the accuracy in diagnosis of bile duct strictures (11,24,(26)(27)(28). The present study differed from our prior experience in that it is the first formal, prospective study directly comparing all these technologies.…”

“…Data were also separately analyzed by considering the presence of Tri-7 as an indicator of a benign process rather than a malignant process. We did so because our preliminary data have demonstrated that this chromosomal aberration is nearly equally indicative of benign or malignant strictures (24,(26)(27)(28).…”

Cholangiocarcinoma: Current Concepts and Insights

“…1 The use of single cell techniques such as digitized image analysis to assess cellular aneuploidy and fluorescent in situ hybridization to quantitate chromosomal duplication are promising for the diagnosis of cholangiocarcinoma 51 ; in one study, they doubled the diagnostic yield obtained with routine brush cytology. 52 Therefore, the absence of a tissue diagnosis is common and the diagnosis of cholangiocarcinoma is often based on composite clinical rather than pathologic criteria. Serum CA 19-9 values greater than 100 U/L in the absence of cholangitis are highly suggestive of cholangiocarcinoma [53][54][55] and may be elevated in up to 85% of patients with this disease.…”

Cholangiocarcinoma: A compact review of the literature

“…New technologies, such as the use of fluorescence in situ hybridization and digital image analysis methods, were reported to be more sensitive than the routine cytology. In one study, these technologies doubled the diagnostic accuracy of brush cytology [47] . The combined use of cholangioscopy improved the diagnostic yield of ERC for CCs.…”