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Value of Multidetector-row Computed Tomography in Diagnosis of Portal Vein Invasion by Perihilar Cholangiocarcinoma

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Abstract

Background

Although knowledge of cancer invasion of the portal bifurcation is vitally important in planning an operation for perihilar cholangiocarcinoma, the diagnostic capability of multidetector-row computed tomography (MDCT) for this purpose has not been assessed. We evaluated how well MDCT could identify cancer invasion of the portal bifurcation by perihilar cholangiocarcinoma.

Methods

Between April 2003 and June 2005, perihilar cholangiocarcinoma was resected in 87 patients, 83 of whom underwent MDCT within 1 month before the surgery. Three-dimensional volume-rendered (3DVR) and multiplanar reformation (MPR) images were examined for evidence of portal vein invasion. Agreement with intraoperative and pathologic findings was assessed. Portal bifurcation findings by 3DVR and MPR were classified into no portal vein stenosis, unilateral stenosis, or more extensive stenosis, and also into tumor contact with the bifurcation in no, one of two, or two projections.

Results

For macroscopic portal vein invasion, sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were 81.5, 91.1, 81.5, 91.1, and 88.0% in 3D portography and 96.3, 92.6, 86.7, 98.1, and 94.0% in MPR, respectively. Findings by both 3DVR and MPR were significantly correlated with depth of cancer invasion (p < 0.001).

Conclusion

MDCT is useful in assessing cancer invasion of the portal vein bifurcation by perihilar cholangiocarcinoma.

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Acknowledgments

The authors are very grateful to Prof. Shigeki Ito, Nagoya University School of Health Science, and radiological technologist Masataka Achiwa, Nagoya University Hospital, for their helpful suggestions and cooperation.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Teiichi Sugiura, Hideki Nishio, Masato Nagino, Yoshiki Senda, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Koji Oda & Yuji Nimura

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  1. Teiichi Sugiura
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  2. Hideki Nishio
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  3. Masato Nagino
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  4. Yoshiki Senda
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  5. Tomoki Ebata
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  6. Yukihiro Yokoyama
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  7. Tsuyoshi Igami
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  8. Koji Oda
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  9. Yuji Nimura
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Correspondence to Masato Nagino.

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Sugiura, T., Nishio, H., Nagino, M. et al. Value of Multidetector-row Computed Tomography in Diagnosis of Portal Vein Invasion by Perihilar Cholangiocarcinoma. World J Surg 32, 1478–1484 (2008). https://doi.org/10.1007/s00268-008-9547-3

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  • DOI: https://doi.org/10.1007/s00268-008-9547-3

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