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Table 1 Characterization of traditional imaging techniques for CCA

From: Multimodal molecular imaging evaluation for early diagnosis and prognosis of cholangiocarcinoma

Technique

Advantages

Limitations

Leading role

US

Inexpensive and simple to conduct

1. Difficulty in differential diagnosis

2. Difficult to assess the range of tumor invasive

First choice for screening

Enhanced CT

1. The sensitivity, specificity and accuracy in the evaluation of primary tumor, vascular and distant metastasis are very high

2. High spatial resolution

1. Radiation

2. Difficult to evaluate longitudinal invasion along the bile duct

Standard imaging mode for CCA diagnosis and staging

MRI/MRCP

1. Comprehensive evaluation of tumor, vascular and bile duct

2. No radiation

3. Multi-plane and multi-parameter imaging

4. Extremely high soft tissue resolution

5. Biliary tree visualization (MRCP)

1. Expensive cost

2. Long inspection time

3. Easy to be disturbed by artifacts

1. Differential diagnosis of difficult cases of CCA (except enhanced CT)

2. Evaluation of longitudinal invasion of ECCA along bile duct

ERCP

1. Evaluate bile duct strictures and intraluminal lesions

2. Both Diagnosis and treatment are feasible

1. Invasive complications

2. Difficult to evaluate the bile duct above the site of obstruction

Pathological diagnosis and biliary drainage

PET

1. Whole-body imaging

2. Extremely sensitive

May lead false positives and false negatives

Determination of distant Metastasis and tumor staging

  1. US, ultrasound; MRCP, MR cholangiopancreatography; ECCA, extrahepatic cholangiocarcinoma; ERCP, endoscopic retrograde cholangiopancreatography