{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:44:26Z","timestamp":1783975466790,"version":"3.55.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Early detection of perihilar cholangiocarcinoma (CCA) among patients with primary sclerosing cholangitis (PSC) is important to identify more people eligible for curative therapy. While many recommend CCA screening, there are divergent opinions and limited data regarding the use of ultrasound or magnetic resonance imaging (MRI) for early CCA detection, and it is unknown whether there is benefit in testing asymptomatic individuals. Our aims were to assess the diagnostic performances and prognostic implications of ultrasound and MRI\u2010based CCA detection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>This is a multicenter review of 266 adults with PSC (CCA, n\u00a0=\u00a0120) who underwent both an ultrasound and MRI within 3\u00a0months. Images were re\u2010examined by radiologists who were blinded to the clinical information. Respectively, MRI had a higher area under the curve compared with ultrasound for CCA detection: 0.87 versus 0.70 for the entire cohort; 0.81 versus 0.59 for asymptomatic individuals; and 0.88 versus 0.71 for those listed for CCA transplant protocol. The absence of symptoms at CCA diagnosis was associated with improved 5\u2010year outcomes including overall survival (82% vs. 46%, log\u2010rank <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.01) and recurrence\u2010free survival following liver transplant (89% vs. 65%, log\u2010rank <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.04). Among those with asymptomatic CCA, MRI detection (compared with ultrasound) was associated with reduction in both mortality (hazard ratio, 0.10; 95% confidence interval, 0.01\u20100.96) and CCA progression after transplant listing (hazard ratio, 0.10; 95% confidence interval, 0.01\u20100.90). These benefits continued among patients who had annual monitoring and PSC for more than 1 year before CCA was diagnosed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>MRI is superior to ultrasound for the detection of early\u2010stage CCA in patients with PSC. Identification of CCA before the onset of symptoms with MRI is associated with improved outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31575","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T05:29:23Z","timestamp":1601011763000},"page":"1868-1881","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":50,"title":["Early Cholangiocarcinoma Detection With Magnetic Resonance Imaging Versus Ultrasound in Primary Sclerosing Cholangitis"],"prefix":"10.1097","volume":"73","author":[{"given":"John E.","family":"Eaton","sequence":"first","affiliation":[{"name":"Division of Gastroenterology & Hepatology,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Welle","sequence":"additional","affiliation":[{"name":"Department of Radiology,Mayo 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Surgery,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie K.","family":"Heimbach","sequence":"additional","affiliation":[{"name":"Division of Transplantation Surgery,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0641-2930","authenticated-orcid":false,"given":"Timucin","family":"Taner","sequence":"additional","affiliation":[{"name":"Division of Transplantation Surgery,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Harnois","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology,Mayo Clinic,Jacksonville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith D.","family":"Lindor","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology,Mayo 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