Staging of extrahepatic cholangiocarcinoma

Chung, Yong Eun; Kim, Do Young; Park, Young Nyun; Lee, Yoon-Hee; Choi, Jin Young

doi:10.1007/s00330-008-1006-x

Cited by 53 publications

(20 citation statements)

References 43 publications

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“…We compared the location, the signal intensity, and the contrast enhancement of PI-CCC (group A) [11–12] compared to metastasis and the peribiliary spaces feature among study population and control study group B (colorectal metastases).…”

Section: Methodsmentioning

confidence: 99%

Diagnostic accuracy of magnetic resonance, computed tomography and contrast enhanced ultrasound in radiological multimodality assessment of peribiliary liver metastases

et al. 2017

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PurposeWe compared diagnostic performance of Magnetic Resonance (MR), Computed Tomography (CT) and Ultrasound (US) with (CEUS) and without contrast medium to identify peribiliary metastasis.MethodsWe identified 35 subjects with histological proven peribiliary metastases who underwent CEUS, CT and MR study. Four radiologists evaluated the presence of peribiliary lesions, using a 4-point confidence scale. Echogenicity, density and T1-Weigthed (T1-W), T2-W and Diffusion Weighted Imaging (DWI) signal intensity as well as the enhancement pattern during contrast studies on CEUS, CT and MR so as hepatobiliary-phase on MRI was assessed.ResultsAll lesions were detected by MR. CT detected 8 lesions, while US/CEUS detected one lesion. According to the site of the lesion, respect to the bile duct and hepatic parenchyma: 19 (54.3%) were periductal, 15 (42.8%) were intra-periductal and 1 (2.8%) was periductal-intrahepatic. According to the confidence scale MRI had the best diagnostic performance to assess the lesion. CT obtained lower diagnostic performance. There was no significant difference in MR signal intensity and contrast enhancement among all metastases (p>0.05). There was no significant difference in CT density and contrast enhancement among all metastases (p>0.05).ConclusionsMRI is the method of choice for biliary tract tumors but it does not allow a correct differential diagnosis among different histological types of metastasis. The presence of biliary tree dilatation without hepatic lesions on CT and US/CEUS study may be an indirect sign of peribiliary metastases and for this reason the patient should be evaluated by MRI.

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Section: Methodsmentioning

confidence: 99%

Diagnostic accuracy of magnetic resonance, computed tomography and contrast enhanced ultrasound in radiological multimodality assessment of peribiliary liver metastases

et al. 2017

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“…The preoperative assessments and tests chosen to preoperatively stage patients with PHC are not uniform 28, 49‐52. Currently, the best imaging modalities for assessing CCA are contrast‐enhanced magnetic resonance imaging and magnetic resonance angiography technology49, 53 (including magnetic resonance cholangiography54, 55).…”

Section: New Proposal By the International Cholangiocarcinoma Group Fmentioning

confidence: 99%

New staging system and a registry for perihilar cholangiocarcinoma

DeOliveira¹,

et al. 2011

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Perihilar cholangiocarcinoma is one of the most challenging diseases with poor overall survival. The major problem for anyone trying to convincingly compare studies among centers or over time is the lack of a reliable staging system. The most commonly used system is the Bismuth-Corlette classification of bile duct involvement, which, however, does not include crucial information such as vascular encasement and distant metastases. Other systems are rarely used because they do not provide several key pieces of information guiding therapy. Therefore, we have designed a new system reporting the size of the tumor, the extent of the disease in the biliary system, the involvement of the hepatic artery and portal vein, the involvement of lymph nodes, distant metastases, and the volume of the putative remnant liver after resection. The aim of this system is the standardization of the reporting of perihilar cholangiocarcinoma so that relevant information regarding resectability, indications for liver transplantation, and prognosis can be provided. With this tool, we have created a new registry enabling every center to prospectively enter data on their patients with hilar cholangiocarcinoma (www.cholangioca.org). The availability of such standardized and multicenter data will enable us to identify the critical criteria guiding therapy. (HEPATOLOGY 2011;53:1363-1371 C holangiocarcinoma (CCA) arises from the malignant transformation of the bile duct epithelium; it represents approximately 10% of all primary hepatobiliary cancers and accounts for approximately 2% of all malignancies.1,2 Several lines of evidence indicate that the incidence of CCA has increased over the past 3 decades.3,4 These tumors can develop anywhere along the biliary tree and represent a quite heterogeneous group with distinct patterns, epidemiologies, clinical presentations, and prognoses. The most commonly used classification of CCA has three groups based on the location along the biliary tree: intrahepatic cholangiocarcinoma (IHC); perihilar cholangiocarcinoma (PHC), which is also called a Klatskin tumor 5 ; and distal CCA. The IHC type accounts for less than 10% of the total cases, whereas the PHC type represents about two-thirds of the cases, and distal CCA represents about a quarter of the cases.6 PHC can be defined as tumors that involve or are in close vicinity to the bile duct confluence. We suggest a definition of PHC, which includes tumors above the junction of the cystic duct up to and including the second biliary branches of the right and left bile ducts.The only chance of a cure for this type of cancer is complete surgical resection of the tumor and perhaps liver transplantation in highly select cases. Most of these cancers have a dismal prognosis, and the current 5-year

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“…Following the current T staging based on the seventh edition of the American Joint Committee on Cancer (AJCC) staging system [26], proximal and distal eCC are differentiated and T1 tumours are limited to the bile duct, whereas T2 tumours extend beyond the wall of the bile duct. With imaging (CT, MRI) and even in histopathology, the exact determination of the border of the bile duct is difficult [27]. Therefore, an accurate preoperative distinction of T1 and T2 tumours does not seem to be possible.…”

Section: Computed Tomographymentioning

confidence: 99%

Imaging of Cholangiocarcinoma

Olthof¹,

Othman²,

Clasen³

et al. 2016

Visc Med

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Cholangiocarcinoma (CC) is the second most common primary hepatobiliary tumour, and it is increasing in incidence. Imaging characteristics, behaviour, and therapeutic strategies in CC differ significantly, depending on the morphology and location of the tumour. In cross-sectional imaging, CCs can be classified according to the growth pattern (mass-forming, periductal infiltrating, intraductal) and the location (intrahepatic, perihilar, extrahepatic/distal). The prognosis of CC is unfavourable and surgical resection is the only curative treatment option; thus, early diagnosis (also in recurrent disease) and accurate staging including the evaluation of lymph node involvement and vascular infiltration is crucial. However, the diagnostic evaluation of CC is challenging due to the heterogeneous nature of the tumour. Diagnostic modalities used in the imaging of CC include transabdominal ultrasound, endosonography, computed tomography, magnetic resonance imaging with cholangiopancreatography, and hybrid imaging such as positron emission tomography/computed tomography. In this review, the potential of cross-sectional imaging modalities in primary staging, treatment monitoring, and detection of recurrent disease will be discussed.

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Staging of extrahepatic cholangiocarcinoma

Cited by 53 publications

References 43 publications

Diagnostic accuracy of magnetic resonance, computed tomography and contrast enhanced ultrasound in radiological multimodality assessment of peribiliary liver metastases

Diagnostic accuracy of magnetic resonance, computed tomography and contrast enhanced ultrasound in radiological multimodality assessment of peribiliary liver metastases

New staging system and a registry for perihilar cholangiocarcinoma

Imaging of Cholangiocarcinoma

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