Multimodality imaging of intrahepatic cholangiocarcinoma

Intrahepatic cholangiocarcinomas account for approximately 20% of cases of cholangiocarcinomas. Three growth patterns or morphologic subtypes exist, including mass-forming, periductal-infiltrating, and intraductal-growth subtypes. Knowledge of these morphologic subtypes and their radiologic appearance aids in timely diagnosis, a key to optimizing patient outcomes. The morphologic variability of intrahepatic cholangiocarcinomas has a direct impact on the diagnostic sensitivity and specificity of various diagnostic imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), and positron emission tomography (PET). The following review emphasizes optimal imaging technique for each of these modalities and reviews the imaging appearance of each morphologic subtype of intrahepatic cholangiocarcinoma.