Non-invasive Diffusion-weighted Imaging With MRCP in the Diagnosis of Neoplastic Biliary Obstruction

Both surgeons and endoscopists value accurate approaches for identifying the source of biliary stricture in patients with obstructive jaundice. Cholangiocarcinoma or a benign stricture may cause a biliary stricture. Many imaging methods were used to diagnose the cause of biliary stricture.

Diffusion-weighted magnetic resonance imaging (DW-MRI) has emerged as a non-invasive imaging modality that can potentially differentiate between malignant and benign biliary obstructions based on the measurement of water diffusion in tissues.

The gold standard of the research is endoscopic retrograde cholangiopancreatography (ERCP) and histology. Patients' diagnoses and follow-up were further verified by ERCP or histopathology.

Inclusion criteria

• Adult patients (≥18 years) with clinically suspected biliary obstruction (e.g., jaundice, elevated liver enzymes, cholestasis).
• Patients who are scheduled for magnetic resonance cholangiopancreatography (MRCP) and have undergone conventional imaging [ultrasound or computed tomography (CT)].
• Patients who will undergo further invasive procedures, e.g., endoscopic retrograde cholangiopancreatography (ERCP), biopsy.

Exclusion criteria

• Patients with contraindications to magnetic resonance imaging (MRI) (e.g., pacemakers, metal implants).
• Patients who have previously undergone major biliary surgery or stent placement.
• Pregnant or lactating women.