The Impact of MDCT and Endoscopic Transpapillary Mapping Biopsy to Predict Longitudinal Spread of Extrahepatic Cholangiocarcinoma

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Kyoji ItoNorihiro Kokudo

Abstract

We aimed to investigate the diagnostic accuracy of multidetector-row computed tomography (MDCT), mapping biopsy, and other imaging modalities to predict the longitudinal extension and depth of invasion of extrahepatic cholangiocarcinoma at possible surgical ductal margins. Of 102 patients with surgical resection of extrahepatic cholangiocarcinoma between January 2010 and October 2015, 32 evaluated by multidetector-row computed tomography (MDCT) performed before biliary drainage and mapping biopsy were enrolled. Mapping biopsies were performed at 74 sites to determine the resection point of the bile duct (at 74 possible surgical ductal margins). Diagnostic accuracy was evaluated by histopathology. The diagnostic accuracy of MDCT for longitudinal cancer spread was 79.7%, that of biopsy was 73.0%, and combining the two modalities showed highest accuracy (83.8%). The depth of tumor invasion could be predicted by combination of the ductal wall thickness and contrast enhancement on MDCT, that is, at 11 of 13 sites (84.6%) with submucosal invasion, ductal wall thickness was > 2.5 mm with high contrast enhancement. MDCT demonstrated highest accuracy of diagnosing longitudinal extension at possible surgical ductal margins in patients wi...Continue Reading

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Citations

Sep 10, 2020·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Dong Ho LeeUNKNOWN Korean Society of Abdominal Radiology
May 10, 2020·Annals of Surgical Oncology·Calogero IaconoAlfredo Guglielmi
Sep 2, 2021·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Pavel SkalickyMartin Lovecek

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