A prospective comparison of the diagnostic accuracy of ERCP, MRCP, CT, and EUS in biliary strictures

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

“…In this instance, MRI plus magnetic resonance cholangiopancreatography represents the imaging procedure with the highest diagnostic accuracy for localizing and sizing the stricture; thus, the challenge is the definitive demonstration of malignancy [208][209][210][211] . For a definitive diagnosis, these patients usually undergo endoscopic retro grade cholangiopancreatography and a number of procedures (cytology, brushing, FISH (fluorescence in situ hybridization)-polisomy, biopsy, intraductal ultrasono graphy, choledochoscopy, cholangioscopy, chromo endoscopy, confocal endoscopy, narrow-band imaging and so on) can be applied for microscopic confirmation, albeit with unsatisfactory sensitivity [212][213][214][215] .…”

“…Biliary strictures, occurring at the time of PSC presentation in 15-20% of patients, might be of malignant nature in 10-15% of the cases 207 . MRI, CT, endoscopic ultrasonography or 18 FDG PET-CT cannot definitively demonstrate the neoplastic nature of the stricture [208][209][210][211]217 . The only condition (either in patients with or without PSC) that does not require histological confirmation is biliary stricture associated with perihilar mass, hypertrophy-atrophy complex and vascular encasement, but this presentation is very rare.…”

Navigator‐triggered isotropic three‐dimensional magnetic resonance cholangiopancreatography in the diagnosis of malignant biliary obstructions: Comparison with direct cholangiography

“…Then, the reviewers assessed the level of obstruction and the extent of disease according to the diagnostic criteria, i.e., loss of continuity of the bile duct, an abrupt and irregular narrowing of a distal segment with prestenotic dilatation, and irregularly shaped intraluminal filling defects (5,6,8). A hilar obstruction was one that occurred at the confluence of the hepatic ducts, in which both the right hepatic and the left hepatic ducts were affected.…”

“…In contrast, MR cholangiopancreatography (MRCP) is an evolving, noninvasive, and highly accurate method of imaging the biliary tree and pancreatic duct (5)(6)(7)(8)(9)(10)(11)(12). Current MRCP techniques typically utilize thick section single-shot rapid acquisition with relaxation enhancement (RARE) and thin section multislice half-Fourier RARE techniques to produce images of the pancreaticobiliary system (11,12).…”

MR imaging findings of early bile duct cancer

“…According to the study by Lim et al (11), early bile duct carcinoma features presenting on imaging studies include the presence of a tumor mass in the bile duct lumen and the preserved integrity of the tumor-bearing bile duct wall with no spread outside the wall. Currently, various invasive and noninvasive imaging modalities, such as ultrasound, CT, MR imaging with/ without MR cholangiopancreatography (MRCP), endoscopic retrograde cholangiography, and endoscopic ultrasound, can be used to diagnose bile duct cancer (2,12). Among these modalities, contrast-en-hanced MR imaging combined with MRCP using stateof-the-art MR scanners, can facilitate viewing longitudinal cancer spread by simultaneously assessing bile ducts upstream and downstream and can permit assessment of the vessels and the depth of invasion (9,(13)(14)(15)(16)(17).…”