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Imaging of Cholangiocarcinoma

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Diagnosis and Management of Cholangiocarcinoma

Abstract

The chapter describes the major non-invasive imaging techniques used in cholangiocarcinoma imaging. These include ultrasound (US), computed tomography (CT), magnetic resonance (MR), as well as nuclear/hybrid imaging, such as positron emission tomography (PET) combined with CT. US is typically used as a first-line screening exam, whereas contrast-enhanced, multiphasic CT and MR are the primary imaging examinations for diagnosis, staging, and surgical planning, due to their excellent performance. PET/CT is becoming increasingly used and has shown additional value in optimizing management in select cases, such as in the detection of lymph node and distal metastatic disease. Imaging utilizes the anatomical classification of cholangiocarcinoma (intrahepatic, perihilar, and distal) along with the major described morphologic growth patterns (mass-forming, periductal infiltrating, and intraductal polypoid); in general, it reflects the heterogeneous presentation of cholangiocarcinoma, with characteristic but nonspecific features that include a metabolically active mass with irregular, peripheral arterial hyperenhancement with gradual centripetal delayed enhancement, as well as biliary ductal dilation with abrupt cutoff at stricture/thickening or mass with normal-caliber distal duct. Herein, we discuss the strengths and limitations of non-invasive imaging modalities in cholangiocarcinoma management.

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Abbreviations

US:

Ultrasound

CT:

Computed tomography

MRI:

Magnetic resonance imaging

PET:

Positron emission tomography

CCA:

Cholangiocarcinoma

iCCA:

Intrahepatic CCA

pCCA:

Perihilar CCA

dCCA:

Distal CCA

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Authors and Affiliations

  1. Department of Radiology, Olive View-UCLA Medical Center, Sylmar, CA, USA

    Karoly Viragh, Shaden Mohammad, Monica Deshmukh & Anokh Pahwa

  2. Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA

    Maitraya Patel

Authors
  1. Karoly Viragh
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  2. Maitraya Patel
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  3. Shaden Mohammad
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  4. Monica Deshmukh
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  5. Anokh Pahwa
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Corresponding author

Correspondence to Karoly Viragh .

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Editors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA

    James H. Tabibian

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Viragh, K., Patel, M., Mohammad, S., Deshmukh, M., Pahwa, A. (2021). Imaging of Cholangiocarcinoma. In: Tabibian, J.H. (eds) Diagnosis and Management of Cholangiocarcinoma. Springer, Cham. https://doi.org/10.1007/978-3-030-70936-5_7

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  • DOI: https://doi.org/10.1007/978-3-030-70936-5_7

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