How We Diagnose Bile Duct Cancer

Diagnostic tests are needed to determine whether symptoms are, in fact, bile duct cancer. If cancer is found, additional tests may be used to assess the stage of the disease; specifically, how advanced the cancer is, and whether it has spread outside the bile duct.

City of Hope diagnostic and staging tests include:
 
A biopsy — taking a small sample of tissue for examination under a microscope — may also be required to confirm a diagnosis of cancer, and to determine the cancer’s stage.
 
Physical exam and history
 
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An abdominal ultrasound is used to diagnose gallbladder cancer.
 
Blood chemistry studies: A procedure in which a blood sample is analyzed to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it.
 
Computerized Axial Tomography (CT or CAT) scan: This procedure uses a computer connected to an X-ray machine to obtain detailed pictures of areas inside the body. A dye may be used to help visualize organs or tissues more clearly.
 
Magnetic Resonance Imaging (MRI): MRI creates a series of detailed pictures of areas inside the body, using the combination of a powerful magnet, radio waves and computer imaging.
 
Positron Emission Tomography (PET) scan: This scan is used to identify malignant cells even before an actual “lump or bump” can be detected in a physical exam, or on CAT or MRI scans. Prior to the scan, a small amount of radionuclide glucose (sugar) is injected into a vein. Because cancer cells divide more frequently than normal cells, they take up more glucose than normal cells and appear brighter in the scan.
 
Endoscopic Retrograde Cholangiopancreatography (ERCP): A thin, flexible tube is guided down the throat, through the stomach, and into the small intestine. The doctor can see through the tube and inject dye into the drainage tube (duct) of the pancreas so that the area can be seen more clearly on an X-ray.
 
Percutaneous Transhepatic Cholangiography (PTC): This is another test that can help find cancer of the extrahepatic bile duct. A thin needle is inserted into the liver through the right side of the patient. Dye is injected through the needle into the bile duct in the liver so that blockages can be seen on X-rays.