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World J Gastrointest Oncol. Jul 15, 2013; 5(7): 115-126
Published online Jul 15, 2013. doi: 10.4251/wjgo.v5.i7.115
Radiological diagnosis and staging of hilar cholangiocarcinoma
Carlos Valls, Sandra Ruiz, Laura Martinez, David Leiva
Carlos Valls, Sandra Ruiz, Laura Martinez, David Leiva, Department of Radiology, Bellvitge University Hospital, Barcelona 08907, Spain
Author contributions: All the authors contributed to the conception, design and interpretation of data and participated in drafting the manuscript, revised it critically and approved the final version; the detailed writing process and analysis of the data was performed by Valls C.
Correspondence to: Dr. Carlos Valls, Department of Radiology, Bellvitge University Hospital, Feixa Llarga s/n L'Hospitalet de Llobregat, Barcelona 08907, Spain. carlosvalls@bellvitgehospital.cat
Telephone: +34-93-3357011 Fax: +34-93-3359011
Received: January 8, 2013
Revised: June 5, 2013
Accepted: June 18, 2013
Published online: July 15, 2013
Processing time: 203 Days and 14.3 Hours
Abstract

Hilar cholangiocarcinoma is a rare malignant tumor arising from the epithelium of the bile ducts. Surgery is still the only chance of potentially curative treatment in patients with perihilar cholangiocarcinoma. However, radical resection requires aggressive surgical strategies that should be tailored optimally according to the location, size and vascular invasion of the tumors. Accurate diagnosis and staging of these tumors is therefore critical for optimal treatment planning and for determining a prognosis. Multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and MR cholangiography are useful tools, both to diagnose and stage hilar cholangiocarcinoma. Modern imaging techniques allow accurate detection of the level of obstruction and the longitudinal and radial spread of the tumor. In addition, high-resolution MDCT and MR provide specific radiographic features to determine vascular involvement of anatomic structures, such as the hepatic artery or the portal vein, which are critical to decide the surgical strategy. Finally, radiological staging allows detection of patients with distant metastasis in the liver or peritoneum who will not benefit from a surgical approach.

Keywords: Cholangiocarcinoma; Radiological staging; Magnetic resonance imaging; Multidetector computed tomography; Hepatic resection

Core tip: Hilar cholangiocarcinoma is a rare malignant tumor arising from the epithelium of the bile ducts. Surgery is still the only chance of potentially curative treatment in patients with perihilar cholangiocarcinoma. Multidetector computed tomography, magnetic resonance imaging and magnetic resonance cholangiography are useful tools, both to diagnose and stage hilar cholangiocarcinoma.