Cholangiocarcinoma imaging: from diagnosis to response assessment.

Cholangiocarcinoma (CCA), a highly aggressive primary liver cancer arising from the bile duct epithelium, represents a substantial proportion of hepatobiliary malignancies, posing formidable challenges in diagnosis and treatment. Notably, the global incidence of intrahepatic CCA has seen a rise, necessitating a critical examination of diagnostic and management strategies, especially due to presence of close imaging mimics such as hepatocellular carcinoma (HCC) and combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA). Hence, it is imperative to understand the role of various imaging modalities such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), elucidating their strengths, and limitations in diagnostic precision and staging accuracy. Beyond conventional approaches, there is emerging significance of functional imaging tools including positron emission tomography (PET)-CT and diffusion-weighted (DW)-MRI, providing pivotal insights into diagnosis, therapeutic assessment, and prognostic evaluation. This comprehensive review explores the risk factors, classification, clinical features, and role of imaging in the holistic spectrum of diagnosis, staging, management, and restaging for CCA, hence serving as a valuable resource for radiologists evaluating CCA.

Imaging Artifacts on Synthesized Mammogram: What a Radiologist should Know!

Synthesized mammogram is a new technique that involves reconstruction of a two-dimensional (2D) image from the tomosynthesis images rather than separate acquisition of a standard 2D mammogram. The advent of a synthesized mammogram (s2D) has helped in reducing radiation exposure. The technique of back projection used in reconstruction makes the appearance of these images different from a standard 2D mammogram. Because this is a relatively new technique, it is associated with a learning curve. Hence, it is important for the new radiologists and technicians to be aware of certain common artifacts encountered while using s2D images, which may hinder interpretation. In this pictorial review, we would like to highlight the common artifacts encountered while reading synthesized mammographic images.