Abstract
AimDiagnostic imaging of early-stage cholangiocarcinoma is challenging. A previous in vitro study of fixed-tissue liver resection specimens investigated T2 mapping as a method of exploiting the locally increased signal-to-noise ratio (SNR) of duodenoscope coils for improved quantitative magnetic resonance imaging (MRI), despite their non-uniform sensitivity. This work applies similar methods to unfixed liver specimens using catheter-based receivers.MethodsEx vivo intraductal MRI and T2 mapping were carried out at 3T on unfixed resection specimens obtained from cholangiocarcinoma patients immediately after surgery using a catheter coil based on a thin-film magneto-inductive waveguide, inserted directly into an intrahepatic duct.ResultsPolypoid intraductal cholangiocarcinoma was imaged using fast spin-echo sequences. High-resolution T2 maps were extracted by fitting of data obtained at different echo times to mono-exponential models, and disease-induced changes were correlated with histopathology. An increase in T2 was found compared with fixed specimens and differences in T2 allowed the resolution of tumour tissue and malignant features such as polypoid morphology.ConclusionDespite their limited field of view, useful data can be obtained using catheter coils, and T2 mapping offers an effective method of exploiting their local SNR advantage without the need for image correction.
Highlights
Cholangiocarcinoma (CCA) is an adenocarcinoma of the biliary tree and the second most common primary malignancy of the liver.[1]
An ex vivo intraductal imaging study was performed on resection specimens from Thai patients with CCA at Khon Kaen University Hospital (KKUH)
The first patient recruited to the study was found to be unresectable during surgery
Summary
Cholangiocarcinoma (CCA) is an adenocarcinoma of the biliary tree and the second most common primary malignancy of the liver.[1]. Metacercariae excyst in the duodenum, pass through the ampulla of Vater into the bile ducts, where they attach to mucosa and develop. Their toxic excretions induce chronic irritation and hyperplasia of the ductal epithelium, oxidative DNA damage and possible malignant transformation.[3] Tumours may be intra- or extrahepatic and are classified into mass-forming, periductal-infiltrating and intraductal types.[4] cholangiocytes are highly diverse[5] and more precise classifications are emerging.[6] Despite education programs, an estimated 9.4% of the Thai population (6 million people) is affected with liver fluke. The most strongly affected region is North-East Thailand, where CCA is responsible for over 25,000 deaths per year.[7] submit your manuscript | www.dovepress.com
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