Diagnosis of intrahepatic cholangiocarcinoma with CEUS
Authors:   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy, Gismondo Velardi Giancarlo , Lico Matilde ,   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy, Teti Angela ,   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy, Maccarone Rosario ,   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy, Casuscelli Giuseppe ,   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy, Militano Letterio ,   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy, Trecroci Ilaria Vittoria ,   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy, Mendicino Maria ,   Department of Radiology, Giovanni Paolo II Hospital, ASP Catanzaro, Lamezia Terme, Italy, Parlati Antonello ,   Department of Radiology, Giovanni Paolo II Hospital, ASP Catanzaro, Lamezia Terme, Italy, De Caridi Adele ,   Department of Radiology, Giovanni Paolo II Hospital, ASP Catanzaro, Lamezia Terme, Italy, Loria Giuseppe ,   Department of Radiology, Giovanni Paolo II Hospital, ASP Catanzaro, Lamezia Terme, Italy, Loria Saverio ,   Faculty of Medicine, UMG, Catanzaro, Italy, Loria Sveva ,   Unicamillus International Medical University, Roma, Italy, Italy, Gambardella Denise ,   Department of Surgery, Giovanni Paolo II Hospital, ASP Catanzaro, Lamezia Terme, Italy, Tedesco Manfredo ,   Department of Surgery, Giovanni Paolo II Hospital, ASP Catanzaro, Lamezia Terme, Italy, Frosina Francesca ,   General Medicine, Asp Reggio Calabria, Reggio Calabria, Italy, Falco Pierluigi ,   Department of Pediatric Oncohematology, Grande Ospedale Metropolitano, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy, Loria Francesco ,   Department of Radiology, Jazzolino Hospital, ASP Vibo Valentia, Vibo Valentia, Italy
Published: February 2024

Intrahepatic cholangiocarcinoma (ICC) is a rare, heterogeneous, highly lethal tumor of the biliary tract. Due to the lack of effective treatments, an early identification of ICC is essential to achieve the best outcome in terms of therapy and prognosis aiming for a curative intent. ICC may arise on a normal liver or with an underlying liver disease, making the diagnosis more difficult and complex. Contrast-enhancement ultrasound (CEUS) is an accurate procedure able to detect ICC-specific contrast vascular pattern, and thus facilitating the correlation between radiological and histopathological findings with high specificity and sensitivity. CEUS has been shown to have a high diagnostic potential in the diagnosis of ICC thanks to the possibility of studying in real time the intralesional microcirculation and evaluating the precocity of the enhancement of the lesion during the arterial phase. All these features allow to differentiate the ICC from hepatocarcinoma (HCC) with high sensitivity and specificity. Furthermore, CEUS is a rapid, non-invasive, non-nephrotoxic or non-allergenic tool. The only limitations CEUS may have are related to the disease site and patient characteristics (obesity) and compliance, including the operator’s experience. A clinical evaluation of the patient, together with tumor markers and biochemical tests assessment, to differentiate ICC from HCC are highly suggested.