title: Advanced techniques for endoscopic biliary imaging: cholangioscopy, endoscopic ultrasonography, confocal, and beyond.
abstract: Cholangioscopy, endosonography, and confocal microscopy represent important technologies that expand biliary imaging beyond a level previously realized by noninvasive modalities (ultrasonography, computed tomography, and magnetic resonance cholangiopancreatography) and endoscopic retrograde cholangiopancreatography. Endoscopic ultrasonography has shown efficacy for the evaluation of indeterminate biliary strictures; however, this modality seems most reliable for distal bile duct abnormalities and in the setting of a moderate to high pretest probability for malignancy. Further refinement of these technologies, validation of their respective diagnostic criteria, and study within the context of comparative, randomized trials are needed and will contribute greatly to expedient patient care.
authors.affiliation: Division of Gastroenterology, Hepatology, & Nutrition, University of Pittsburgh Medical Center, 200 Lothrop Street, C Wing, Mezzanine Level, Pittsburgh, PA 15213, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Gabbert
authors.forename: Matthew
authors.initials: M
authors.lastname: Warndorf
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Easler
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chennat
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D042883:Choledocholithiasis / Q000175:diagnosis* / Q000628:therapy; D003251:Constriction, Pathologic / Q000175:diagnosis*; D004724:Endoscopy / Q000379:methods; D019160:Endosonography / Q000379:methods; D006801:Humans; D018613:Microscopy, Confocal / Q000379:methods