Erschienen in:
15.05.2018 | Original Article
The Impact of MDCT and Endoscopic Transpapillary Mapping Biopsy to Predict Longitudinal Spread of Extrahepatic Cholangiocarcinoma
verfasst von:
Kyoji Ito, Yoshihiro Sakamoto, Hiroyuki Isayama, Yosuke Nakai, Takeyuki Watadani, Mariko Tanaka, Tetsuo Ushiku, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa, Norihiro Kokudo
Erschienen in:
Journal of Gastrointestinal Surgery
|
Ausgabe 9/2018
Einloggen, um Zugang zu erhalten
Abstract
Backgrounds
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.
Methods
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.
Results
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.
Conclusions
MDCT demonstrated highest accuracy of diagnosing longitudinal extension at possible surgical ductal margins in patients with extrahepatic cholangiocarcinoma. The depth of tumor invasion could be predicted by ductal wall thickness and contrast enhancement of MDCT.