Radiological assessment of secondary biliary tree lesions: an update

Abstract

Objective To conduct a systematic literature review of imaging techniques and findings in patients with peribiliary liver metastasis. Methods Several electronic datasets were searched from January 1990 to June 2017 to identify studies assessing the use of different imaging techniques for the detection and staging of peribiliary metastases. Results The search identified 44 studies, of which six met the inclusion criteria and were included in the systematic review. Multidetector computed tomography (MDCT) is the technique of choice in the preoperative setting and during the follow-up of patients with liver tumors. However, the diagnostic performance of MDCT for the assessment of biliary tree neoplasms was low compared with magnetic resonance imaging (MRI). Ultrasound (US), without and with contrast enhancement (CEUS), is commonly employed as a first-line tool for evaluating focal liver lesions; however, the sensitivity and specificity of US and CEUS for both the detection and characterization are related to operator expertise and patient suitability. MRI has thus become the gold standard technique because of its ability to provide morphologic and functional data. MRI showed the best diagnostic performance for the detection of peribiliary metastases. Conclusions MRI should be considered the gold standard technique for the radiological assessment of secondary biliary tree lesions.

Diffusion weighted imaging and diffusion kurtosis imaging in abdominal oncological setting: why and when

“…The spread in expertise in cancer and the opportunity to obtain a tailored treatment by choosing a proper approach, as well as the management of patients within a multidisciplinary team has increased the patient prognosis [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69]. In this scenario, the possibility to use a diagnostic tool that evaluates cancer characteristics at microscopic level explains the reasons for the great attention on DWI [70][71][72][73][74][75][76].…”

Radiological Approach to Diagnosis of Peribiliary Lesions

“…MRI is considered a better modality than CT for detecting metastasis. 20,25 Small lesions are very difficult to detect on CT because the lesion characteristic is difficult to differentiate from that of the adjacent liver parenchyma. Indirect signs such as bile duct dilatation are more helpful in detecting larger lesions, and this finding can direct the patient to an MRI for further evaluation.…”

“…Peribiliary metastasis are best detected on T2W MRI and DWI. 25 The high spatial and contrast resolution allow accurate tumor detection and staging. PET is a sensitive technique for the detection of peribiliary tumors, it is not specific in their differential diagnosis.…”

Diagnostic evaluation and ablation treatments assessment in hepatocellular carcinoma

“…The contrast agent spreads through the human body, emphasizing the vessel structure in the region of interest [22]. This technology leads to the highlighting of both large vessel flows, as well as of the microcirculation, being firstly implemented for hepatic tumor pathology, for abdominal emergencies and in order to recognize various tumor types [26][27][28][29][30][31][32][33][34][35][36]. The microbubbles of the contrast agent produce harmonic echoes, which are detected by the transducer.…”