Abstracts

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E1888. Cholangiocarcinoma Imaging: Pearls and Pitfalls
Authors
  1. Surbhi Trivedi; University of Illinois Hospital & Health Sciences System
  2. Winnie Mar; University of Illinois Hospital & Health Sciences System
  3. Hing Kiu Chan; University of Illinois Hospital & Health Sciences System
  4. Brian Tae Kim; University of Illinois Hospital & Health Sciences System
  5. Darshan Gandhi; Northwestern University Feinberg School of Medicine
  6. Senta Berggruen; Northwestern University Feinberg School of Medicine
Background
Cholangiocarcinoma (CC) is the second most common primary hepatic tumor. Imaging plays a key role in diagnosis, staging and prognosis.

Educational Goals / Teaching Points
The goal of this abstract is to review the varied imaging patterns for cholangiocarcinoma, including intrahepatic versus extrahepatic location, different morphologies of mass forming, periductal infiltrating or intraductal growing, as well as understanding benign and malignant imaging mimics. Staging of tumor with the Bismuth Corlette system and TNM will also be discussed.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The imaging characteristics of the different morphologies and locations of cholangiocarcinoma will be reviewed, with a focus on CT and MR imaging. Pearls to help differentiate between hepatocellular carcinoma and cholangiocarcinoma, which can be a challenge particularly in patients with cirrhosis, will be discussed. The appearance of combined hepatocellular carcinoma - cholangiocarcinoma will also be reviewed. Pre-invasive biliary lesions including biliary intraductal papillary mucinous neoplasm will also be discussed. A prognostic feature in mass forming cholangiocarcinoma, with lower survival associated with an increased quantity of fibrous stromal tissue, will be noted.

Conclusion
Imaging plays an important role in detection and staging of cholangiocarcinoma. Radiologists should be familiar with the different presentations of this disease.