Associations between ultrasound screening findings and cholangiocarcinoma diagnosis in an at-risk population

Abstract

The rate of cholangiocarcinoma (CCA) is increasing every year, especially in northeastern Thailand. Screening for CCA using ultrasonography (US) is the fastest technique to identify patients in early stage of CCA development. Currently, few studies have examined patterns of hepatobiliary abnormalities identifed using US, which can be indicative of CCA. We aim to evaluate the rate of CCA and its relations to history of US fndings. Our study included participants who underwent US and pathological diagnosis of CCA from the Cholangiocarcinoma Screening and Care Program, Northeast Thailand between 2013 and 2020. Data on histological fndings were based on the standard protocol of the tertiary hospital at Khon Kaen University. CCA data is categorized into two groups (yes/no) to fnd the relationship with history of US fndings. The adjusted odds ratio (AOR) and their 95% confdence intervals (CI) were used to evaluate the relationship obtained by multiple logistic regression. Of 1880 subjects who underwent US and a pathological diagnosis of CCA, the overall rate of CCA was 35.74%. CCA rate among those with liver mass (LM) was 54.85% and with dilated bile duct (DBD) was 62.01%. The relationship between DBD and CCA was highly signifcant (AOR= 3.46; 95% CI 2.74–4.36) followed by LM (AOR= 2.28; 95% CI 1.81–2.86) P value < 0.001. Our study reveals that US fndings history have a strong association with CCA, especially in people diagnosed with DBD and LM. Therefore, these abnormalities can be indicators for suspected CCA diagnosis through US.