Comparison Between Multidetector CT and High–Field 3T MR Imaging in Diagnostic and Tumour Extension Evaluation of Patients with Cholangiocarcinoma

• Published in: Journal of gastrointestinal cancer Vol. 51; no. 2; pp. 534 - 544
• Main Authors: D’Antuono, Felice, De Luca, Serena, Mainenti, Pier Paolo, Mollica, Carmine, Camera, Luigi, Galizia, Gennaro, Brunetti, Arturo, Maurea, Simone
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-06-2020
• Subjects: Aged; Aged, 80 and over; Bile Duct Neoplasms - diagnostic imaging; Cancer Research; Cholangiocarcinoma - diagnostic imaging; Female; Gastroenterology; Humans; Internal Medicine; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography - methods; Oncology; Original Research; Radiotherapy; Computed tomography; Magnetic resonance imaging; Bile ducts; Cholangiocarcinoma; Comparative study
• ISSN: 1941-6628; 1941-6636
• DOI: 10.1007/s12029-019-00276-z

Purpose
To compare multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) with cholangiopancreatography (MRCP) findings in the diagnostic evaluation of patients with cholangiocarcinoma (CCA) to establish tumour resectability.
Methods
Thirty patients (22 M, 8 F) with pathologically proven CCA by post-surgical specimens (
n
 = 20), core biopsy (
n
 = 6) or cytology (
n
 = 4) underwent both MDCT and MRI with MRCP. CCA lesions were classified on the basis of anatomical locations in intra-hepatic (iCCA), peri-hilar (pCCA) and distal (dCCA) tumours. Morphological tumour pattern, lesion size, biliary dilatation, tumour contrast enhancement type, lymph node involvement and vascular infiltration were directly compared between MDCT and MRI with MRCP. As a rule, a tumour resectability judgement for each patient was formulated by both imaging techniques comparing imaging results with direct surgical assessment (
n
 = 20) or interventional procedures (
n
 = 10).
Results
In terms of anatomical location, 14 iCCA, 8 pCCA and 8 dCCA were observed; both imaging techniques were concordant about the identification and morphological characterization of tumour lesions and in the evaluation of tumour features (lesion size, contrast enhancement pattern, capsular retraction, biliary dilatation, lymph node involvement and vascular infiltration) as well as in assessing lesion resectability; an excellent agreement (
k
 = 1) for the assessment of all the parameters included in imaging analysis was observed.
Conclusions
The comparative concordant results of our study suggest that MRI with MRCP represents a valid alternative to MDCT for the diagnostic evaluation of patients with CCA to establish tumour resectability providing multiplanar scanning of high-contrast imaging quality; MDCT should be preferred in uncooperative patients, in the presence of biliary stents or when MRI is absolutely contraindicated for incompatible medical devices.