title: Diagnostic accuracy of multidetector-row computed tomography for hilar cholangiocarcinoma.
abstract: OBJECTIVE
  The aim of this study was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for the evaluation of tumor spread in hilar cholangiocarcinoma.
  
  
  METHODS
  Images obtained from a 16-detector row scanner of 22 patients were interpreted. The diagnostic accuracy of longitudinal ductal spread, vertical invasion (including hepatic parenchyma), and lymph node metastasis was assessed with reference to histopathological findings.
  
  
  RESULTS
  The location of the tumor was correctly diagnosed in 95% of cases (21/22), but in five of these cases, the cut end of the intrahepatic bile duct was positive, resulting in 77% diagnostic accuracy for longitudinal spread. Among the patients with a negative bile duct surgical margin, there was a significant difference in the measurement of tumor spread between MDCT and microscopic investigation (P < 0.001). For vertical invasion, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT were 69%, 100%, 100%, and 69% for the liver parenchyma, respectively. The sensitivity, specificity, PPV, and NPV of MDCT for lymph node metastasis were 50%, 75%, 43%, and 80%, respectively.
  
  
  CONCLUSIONS
  The diagnostic accuracy of MDCT for tumor location and vertical invasion was satisfactory, but ductal spread was underestimated in comparison with microscopic measurements.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Saitama Medical University, Saitama, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Hisato
authors.initials: H
authors.lastname: Osada
authors.forename: Takenori
authors.initials: T
authors.lastname: Okada
authors.forename: Shinji
authors.initials: S
authors.lastname: Itoyama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Komagome
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Shin
authors.forename: Narihiro
authors.initials: N
authors.lastname: Cho
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishida
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ozawa
authors.forename: Daijo
authors.initials: D
authors.lastname: Hashimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed