Improved Diagnosis of Adjacent Organ Invasion of Extrahepatic Cholangiocarcinoma by Adding Arterial and Delayed Phases

• Published in: Curēus (Palo Alto, CA) CA), 2023-10, Vol.15 (10), p.e47568-e47568
• Main Authors: Mukaida, Eisuke, Tamura, Akio, Kato, Kenichi, Ota, Yoshitaka, Kasugai, Satoshi, Katagiri, Hirokatsu, Nitta, Hiroyuki, Masao, Nishiya, Yanagawa, Naoki, Yoshioka, Kunihiro
• Format: Article
• Language: English
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.47568

PURPOSETo clarify the role of dynamic computed tomography (CT) in diagnosing extrahepatic cholangiocarcinoma (eCCA) involving adjacent organs.MATERIAL AND METHODSWe retrospectively analyzed patients diagnosed with eCCA in Iwate Medical University Hospital (Morioka, Japan) during January 2011-December 2021 who underwent dynamic contrast-enhanced CT before biliary intervention, surgery, or chemotherapy. For surgical cases, two radiologists independently reviewed CT images in the portal, dual (adding arterial phase), and triple (adding delayed phase) phases. The mean attenuations of the abdominal aorta, portal vein (PV), hepatic parenchyma, pancreatic parenchyma, and eCCA were measured. The biliary segment-wise longitudinal tumour extent, arterial and PV invasion, organ invasion (liver, pancreas, and duodenum), and regional lymph node metastasis were assessed on a five-point scale. Image performances were compared using the sensitivity, specificity, and area under the curve (AUC).RESULTSWe included 120 patients (mean age, 71.7 ± 8.9; 84 males). The PV and liver differed most from the bile duct tumour in the portal phase. The abdominal aorta and pancreas differed most from eCCA in the arterial phase. For 80 patients evaluated on the five-point scale, adding phases increased the AUC for pancreatic, duodenal, and arterial invasion for each observer (observer 1, 0.79-0.93, p