The Importance of Imaging Techniques in the Assessment of Biliary Tract Cancer

Biliary tract cancer is reported to be uncommon among most countries in Europe. On the other hand, higher incidence values were recorded in Southeast Asia due to various local hepatobiliary flukes and other risk factors. The malignant process can develop anywhere along the biliary tract and it can be divided into three different types according to their anatomic location: cholangiocarcinoma, carcinoma of the ampulla of Vater and gallbladder cancer. The biggest problem that we are currently facing with this type of malignancy is that patients are usually diagnosed in late stages with few alternatives regarding therapy. Due to its silent, yet fatal evolution, clinicians require additional help from imaging techniques. Initial evaluation of the biliary tract is usually performed with the help of ultrasonography (US) which can determine if an additional imaging procedure will be required next for further evaluation. Some of these imaging techniques include magnetic resonance imaging (MRI), computed tomography (CT), percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiopancreatography (ERCP) and MRI with magnetic resonance cholangiopancreatography (MRCP). The purpose of this Review is to evaluate the advantages and disadvantages of various imaging procedures for the assessment in this type of malignancy.