Intrahepatic peripheral cholangiocarcinoma: CT evaluation

Valls, Carme; Gumà, Anna; Puig, Ignasi; Sánchez, Anna; Andía, Eduard; Serrano, Teresa; Figueras, Juan

doi:10.1007/s002610000079

Cited by 182 publications

(72 citation statements)

References 8 publications

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“…On unenhanced CT, mCCA presents as a homogeneously hypo-to isoattenuating mass with lobulated margins (2,38,39). After administration of iodinated contrast, the pattern of enhancement may be somewhat variable but is usually an accurate reflection of the histologic composition of the mass.…”

Section: Ctmentioning

confidence: 99%

“…After administration of iodinated contrast, the pattern of enhancement may be somewhat variable but is usually an accurate reflection of the histologic composition of the mass. Generally speaking, the periphery of the tumor is composed of active tumor cells, whereas the center of the tumor is composed of desmoplastic stroma, necrotic tissue, or mucin (2,18,38,39).…”

Section: Ctmentioning

confidence: 99%

See 1 more Smart Citation

Multimodality imaging of intrahepatic cholangiocarcinoma

Fábrega-Foster¹,

Ghasabeh²,

Pawlik³

et al. 2017

Hepatobiliary Surg. Nutr.

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Intrahepatic cholangiocarcinomas account for approximately 20% of cases of cholangiocarcinomas.Three growth patterns or morphologic subtypes exist, including mass-forming, periductal-infiltrating, and intraductal-growth subtypes. Knowledge of these morphologic subtypes and their radiologic appearance aids in timely diagnosis, a key to optimizing patient outcomes. The morphologic variability of intrahepatic cholangiocarcinomas has a direct impact on the diagnostic sensitivity and specificity of various diagnostic imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), and positron emission tomography (PET).The following review emphasizes optimal imaging technique for each of these modalities and reviews the imaging appearance of each morphologic subtype of intrahepatic cholangiocarcinoma.

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Section: Ctmentioning

confidence: 99%

Section: Ctmentioning

confidence: 99%

Multimodality imaging of intrahepatic cholangiocarcinoma

Fábrega-Foster¹,

Ghasabeh²,

Pawlik³

et al. 2017

Hepatobiliary Surg. Nutr.

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“…Current imaging modalities such as CT and magnetic resonance imaging provide useful diagnostic information on malignant liver tumors [19], and imaging analysis is important for defining the indications for surgery [30]. The predominant radiological characteristic of ICC is that of hypovascular or marginally delayed enhancement of the mass in the portal phase [8,20,21,31,32], but tumor morphology and vascularity show different characteristics in some ICCs, particularly peripheral lesions [20,21,[33][34][35][36]. Differences in tumor vascularity may be caused by differences in the background liver injury or cancer cell origin.…”

Section: Nanashima Et Al Page 10mentioning

confidence: 99%

Intrahepatic cholangiocarcinoma: relationship between tumor imaging enhancement by measuring attenuation and clinicopathologic characteristics

et al. 2012

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Purpose: Arterial enhancement of intrahepatic cholangiocarcinoma (ICC) has been noted. To precisely identify the characteristics of tumor enhancement patterns, we examined the relationship between CT attenuation in the tumor and clinicopathological parameters or prognosis.Methods: Subjects were 42 ICC patients who had undergone hepatectomy. Microvessel density (MVD) determined by CD34 staining was compared with imaging. Attenuation was calculated in images from multi-detector CT of tumor and non-tumorous regions. Enhancement patterns were divided into two groups: arterial enhancement with higher attenuation (>16 HU; Hyper group, n=12); and arterial enhancement with lower attenuation (Hypo group, n=30).Results: Univariate analysis identified high tumor marker level, increased size, less-differentiation, incomplete resection, increased bleeding and lower MVD as significantly associated with poor survival (p<0.05). Increased attenuation throughout the whole ICC correlated significantly with radiological findings and MVD. Concomitant hepatitis, well-differentiation, and smaller tumor were more significantly frequent in the Hyper group than in the Hypo group (p<0.05). Postoperative early recurrence was significantly less frequent in the Hyper group, and overall survival was significantly better in the Hyper group (p<0.05). Conclusions:Increased CT attenuation correlated with ICC tumor vascularity. Increased tumor enhancement in the arterial phase was associated with chronic hepatitis, lower malignancy and better survival.Key words: intrahepatic cholangiocarcinoma-tumor enhancement-multidetector computed tomography-prognosis-hepatectomy Nanashima et al., Page 3 Intrahepatic cholangiocarcinoma (ICC) is a well-characterized liver cancer for which various prognostic risk factors have been clarified [1][2][3]. ICC is composed of cells that mostly resemble those of the peripheral bile ducts, but recent reports have suggested that ICC may not always display uniform characteristics [4][5][6][7][8]. ICC can be classified into subgroups according to macroscopic findings, with clinical and pathological characteristics and prognosis differing significantly among subgroups [9,10].While diagnosis of the ICC subtype would be useful for predicting prognosis and determining the need for adjuvant treatments with hepatic resection, clearly distinguishing subgroups is often difficult, particularly in advanced tumors. Although a variety of prognostic parameters have been identified in recent research, the definitive factors associated with poor prognosis have not been well clarified [11,12]. Recent histological and molecular studies have revealed that tumor vascularity of ICC is closely associated with malignant behavior and patient prognosis [13,14]. Higher tumor vascularity might be related to the presence of chronic viral hepatitis, which is also related to carcinogenesis for hepatocellular carcinoma (HCC) [15]. We have previously examined histological parameters in ICC and clarified that higher tumor vascularity as dete...

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“…Triple-phase CT scan is widely used to diagnose and stage CC [88] as it provides valuable information regarding local spread, vascular invasion, lymph node involvement and presence of distant metastases [89,90] . On CT scans, ICC usually present as hypodense lesions with irregular margins on initial images and a variable degree of delayed venous phase enhancement [86] .…”

Section: Computed Tomography (Ct)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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Intrahepatic peripheral cholangiocarcinoma: CT evaluation

Abstract: In the proper clinical setting, detection of a hypodense hepatic lesion with peripheral enhancement, biliary dilatation, and contrast enhancement on delayed images are highly suggestive of peripheral intrahepatic cholangiocarcinoma.

Cited by 182 publications

References 8 publications

Multimodality imaging of intrahepatic cholangiocarcinoma

Multimodality imaging of intrahepatic cholangiocarcinoma

Intrahepatic cholangiocarcinoma: relationship between tumor imaging enhancement by measuring attenuation and clinicopathologic characteristics

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

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