High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma
Introduction Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomograpy (HRCT) to determine resect...
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2007
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| Online Access: | http://hdl.handle.net/10725/2552 http://dx.doi.org/10.1016/j.amjsurg.2006.10.024 http://www.sciencedirect.com/science/article/pii/S0002961007001997 |
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| _version_ | 1864513458628722688 |
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| author | Aloia, Thomas |
| author2 | Chamsangavej, Chulsip Faria, Silvana Ribero, Dario Abdalla, Eddie Vauthey, Nicolas Curley, Steven |
| author2_role | author author author author author author |
| author_facet | Aloia, Thomas Chamsangavej, Chulsip Faria, Silvana Ribero, Dario Abdalla, Eddie Vauthey, Nicolas Curley, Steven |
| author_role | author |
| dc.creator.none.fl_str_mv | Aloia, Thomas Chamsangavej, Chulsip Faria, Silvana Ribero, Dario Abdalla, Eddie Vauthey, Nicolas Curley, Steven |
| dc.date.none.fl_str_mv | 2007 2015-11-12T12:30:49Z 2015-11-12T12:30:49Z 2015-11-12 |
| dc.identifier.none.fl_str_mv | 0002-9610 http://hdl.handle.net/10725/2552 http://dx.doi.org/10.1016/j.amjsurg.2006.10.024 Aloia, T. A., Charnsangavej, C., Faria, S., Ribero, D., Abdalla, E. K., Vauthey, J. N., & Curley, S. A. (2007). High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma. The American journal of surgery, 193(6), 702-706. http://www.sciencedirect.com/science/article/pii/S0002961007001997 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | The American Journal of Surgery |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Introduction Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomograpy (HRCT) to determine resectability in this setting. Patients and Methods Preoperative helical HRCT (2 contrast phases, rapid intravenous contrast bolus, 2.5-mm section thickness) for 32 consecutive patients who underwent laparotomy for the diagnosis of hilar cholangiocarcinoma from 2000 to 2005 were reviewed by a hepatobiliary radiologist. The accuracy of HRCT was determined by comparison of the imaging interpretation to intraoperative and pathologic findings. The chi-square test was used to identify imaging findings that best predicted unresectability. Results Fourteen of the 32 (44%) study patients were unresectable (extension along bile duct, 4; peritoneal metastases, 4; vascular encasement, 3; noncontiguous liver metastases, 2; N2 lymphadenopathy, 1). HRCT correctly predicted resectability in 17 of 18 patients who underwent therapeutic laparotomy (sensitivity = 94%). HRCT correctly predicted the inability to resect in 11 of the remaining 14 cases (specificity = 79%). In the 3 cases in which HRCT predicted resectability and the patient was unresectable, subcentimeter peritoneal disease, a subcentimeter liver metastasis, and distal bile duct involvement were responsible factors. The negative and positive predictive values of HRCT were 92% and 85%, respectively. Individual radiographic findings that best predicted unresectability were peritoneal spread (P = .015) and hepatic artery (P = .006) or portal vein (P = .002) involvement. Conclusions Preoperative HRCT accurately predicts resectability in patients with hilar cholangiocarcinoma. Identification of specific radiographic features, in particular major vascular involvement and peritoneal abnormalities, is now used by our group to avoid unnecessary laparotomy. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_72cd9bbb873913eb8f03a36e4b1cb116 |
| identifier_str_mv | 0002-9610 Aloia, T. A., Charnsangavej, C., Faria, S., Ribero, D., Abdalla, E. K., Vauthey, J. N., & Curley, S. A. (2007). High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma. The American journal of surgery, 193(6), 702-706. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2552 |
| publishDate | 2007 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinomaAloia, ThomasChamsangavej, ChulsipFaria, SilvanaRibero, DarioAbdalla, EddieVauthey, NicolasCurley, StevenIntroduction Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomograpy (HRCT) to determine resectability in this setting. Patients and Methods Preoperative helical HRCT (2 contrast phases, rapid intravenous contrast bolus, 2.5-mm section thickness) for 32 consecutive patients who underwent laparotomy for the diagnosis of hilar cholangiocarcinoma from 2000 to 2005 were reviewed by a hepatobiliary radiologist. The accuracy of HRCT was determined by comparison of the imaging interpretation to intraoperative and pathologic findings. The chi-square test was used to identify imaging findings that best predicted unresectability. Results Fourteen of the 32 (44%) study patients were unresectable (extension along bile duct, 4; peritoneal metastases, 4; vascular encasement, 3; noncontiguous liver metastases, 2; N2 lymphadenopathy, 1). HRCT correctly predicted resectability in 17 of 18 patients who underwent therapeutic laparotomy (sensitivity = 94%). HRCT correctly predicted the inability to resect in 11 of the remaining 14 cases (specificity = 79%). In the 3 cases in which HRCT predicted resectability and the patient was unresectable, subcentimeter peritoneal disease, a subcentimeter liver metastasis, and distal bile duct involvement were responsible factors. The negative and positive predictive values of HRCT were 92% and 85%, respectively. Individual radiographic findings that best predicted unresectability were peritoneal spread (P = .015) and hepatic artery (P = .006) or portal vein (P = .002) involvement. Conclusions Preoperative HRCT accurately predicts resectability in patients with hilar cholangiocarcinoma. Identification of specific radiographic features, in particular major vascular involvement and peritoneal abnormalities, is now used by our group to avoid unnecessary laparotomy.PublishedN/A2015-11-12T12:30:49Z2015-11-12T12:30:49Z20072015-11-12Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0002-9610http://hdl.handle.net/10725/2552http://dx.doi.org/10.1016/j.amjsurg.2006.10.024Aloia, T. A., Charnsangavej, C., Faria, S., Ribero, D., Abdalla, E. K., Vauthey, J. N., & Curley, S. A. (2007). High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma. The American journal of surgery, 193(6), 702-706.http://www.sciencedirect.com/science/article/pii/S0002961007001997enThe American Journal of Surgeryinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/25522016-08-25T10:06:22Z |
| spellingShingle | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma Aloia, Thomas |
| status_str | publishedVersion |
| title | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma |
| title_full | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma |
| title_fullStr | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma |
| title_full_unstemmed | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma |
| title_short | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma |
| title_sort | High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma |
| url | http://hdl.handle.net/10725/2552 http://dx.doi.org/10.1016/j.amjsurg.2006.10.024 http://www.sciencedirect.com/science/article/pii/S0002961007001997 |