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Imaging spectrum of cholangiocarcinoma: role in diagnosis, staging, and posttreatment evaluation

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Abstract

Cholangiocarcinoma, a tumor of biliary epithelium, is increasing in incidence. The imaging appearance, behavior, and treatment of cholangiocarcinoma differ according to its location and morphology. Cholangiocarcinoma is usually classified as intrahepatic, perihilar, or distal. The three morphologies are mass-forming, periductal sclerosing, and intraductal growing. As surgical resection is the only cure, prompt diagnosis and accurate staging is crucial. In staging, vascular involvement, longitudinal spread, and lymphadenopathy are important to assess. The role of liver transplantation for unresectable peripheral cholangiocarcinoma will be discussed. Locoregional therapy can extend survival for those with unresectable intrahepatic tumors. The main risk factors predisposing to cholangiocarcinoma are parasitic infections, primary sclerosing cholangitis, choledochal cysts, and viral hepatitis. Several inflammatory conditions can mimic cholangiocarcinoma, including IgG4 disease, sclerosing cholangitis, Mirizzi’s syndrome, and recurrent pyogenic cholangitis. The role of PET in diagnosis and staging will also be discussed. Radiologists play a crucial role in diagnosis, staging, and treatment of this disease.

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Acknowledgments

We thank David Botos for the illustrations and image preparation.

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Authors and Affiliations

  1. Department of Radiology, University of Illinois at Chicago, 1740 W Taylor St Rm 2483, MC 931, Chicago, IL, 60612, USA

    Winnie A. Mar, Andrew M. Shon, Yang Lu, Jonathan H. Yu & Charles E. Ray Jr.

  2. Department of Radiology, Northwestern University, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago, IL, 60611, USA

    Senta M. Berggruen & Frank Miller

  3. Department of Pathology, University of Illinois at Chicago, 840 S. Wood St., Suite 130 CSN, MC 847, Chicago, IL, 60612, USA

    Grace Guzman

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  1. Winnie A. Mar
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Correspondence to Winnie A. Mar.

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Mar, W.A., Shon, A.M., Lu, Y. et al. Imaging spectrum of cholangiocarcinoma: role in diagnosis, staging, and posttreatment evaluation. Abdom Radiol 41, 553–567 (2016). https://doi.org/10.1007/s00261-015-0583-9

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