High quality cross-sectional Multidetector Computed Tomography and/or Magnetic Resonance Imaging play an important role in diagnosis, localization, and staging and planning of the optimal management of cholangiocarcinoma. Correct imaging helps to localize the tumor to either the intrahepatic, the perihilar or the distal bile ducts, each of which requires different management. It accurately stages the disease, identifying the presence of significant nodal and distant metastasis or major vascular encasement of the portal vein or the hepatic arteries, or depicts extensive involvement of the hepatic duct reaching up to second-order biliary radicals. It also helps to identify the extent of local tumor invasion, which has a major impact on management.
This chapter presents the spectrum of appearances of cholangiocarcinomas at cross-sectional imaging and examines the possibilities of imaging modalities in the proper stage classification of bile duct tumors according to the recent staging systems
