Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Feb 28, 2015; 7(2): 28-44
Published online Feb 28, 2015. doi: 10.4329/wjr.v7.i2.28
Imaging and interventions in hilar cholangiocarcinoma: A review
Kumble Seetharama Madhusudhan, Shivanand Gamanagatti, Arun Kumar Gupta
Kumble Seetharama Madhusudhan, Shivanand Gamanagatti, Arun Kumar Gupta, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi 110029, India
Author contributions: All the authors equally contributed to this work.
Conflict-of-interest: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Shivanand Gamanagatti, Additional Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar East, Gautam Nagar, New Delhi, Delhi 110029, India.
Telephone: +91-11-26594567 Fax: +91-11-26588660
Received: October 8, 2014
Peer-review started: October 8, 2014
First decision: November 1, 2014
Revised: November 14, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: February 28, 2015

Hilar cholangiocarcinoma is a common malignant tumor of the biliary tree. It has poor prognosis with very low 5-year survival rates. Various imaging modalities are available for detection and staging of the hilar cholangiocarcinoma. Although ultrasonography is the initial investigation of choice, imaging with contrast enhanced computed tomography scan or magnetic resonance imaging is needed prior to management. Surgery is curative wherever possible. Radiological interventions play a role in operable patients in the form of biliary drainage and/or portal vein embolization. In inoperable cases, palliative interventions include biliary drainage, biliary stenting and intra-biliary palliative treatment techniques. Complete knowledge of application of various imaging modalities available and about the possible radiological interventions is important for a radiologist to play a critical role in appropriate management of such patients.We review the various imaging techniques and appearances of hilar cholangiocarcinoma and the possible radiological interventions.

Keywords: Cholangiocarcinoma, Biliary malignancy, Imaging, Biliary intervention, Computed tomography, Magnetic resonance imaging

Core tip: Poor prognosis of hilar cholangiocarcinoma mandates early diagnosis. The article outlines the performance of various imaging modalities in making a diagnosis and allows the readers to decide the appropriately modality in a given case. Further, the brief descriptions of a wide range of radiological interventions in hilar cholangiocarcinoma educate the readers about the available options and choose them judiciously.