ArticleAbdominal radiology (New York)2019
Differentiating IgG4-related sclerosing cholangiopathy from cholangiocarcinoma using CT and MRI: experience from a tertiary referring center.
Article in Abdominal radiology (New York), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 20 citations in OpenAlex.
- Diagnostic Imaging of Pancreatic and Biliary Involvement in IgG4-Related Disease: Key Imaging Features, Diagnostic Criteria and Differential Diagnosis.Diagnostics (Basel, Switzerland) · 2026Review
- Clinical features, responses to therapy and prognosis of 107 patients with IgG4-related cholangitis: a retrospective study.BMC gastroenterology · 2026Observational
- Diagnostic pitfalls in IgG4-related sclerosing cholangitis presenting as perihilar cholangiocarcinoma: case report with literature review.Frontiers in immunology · 2026Review
- ESGAR consensus statement on MR imaging in primary sclerosing cholangitis.European radiology · 2025Article
- IgG4-Related Cholangitis.Seminars in liver disease · 2025Review
- Gallbladder and biliary pathology: lessons learned from multidisciplinary conference.Abdominal radiology (New York) · 2025Review
- Management of IgG4-related cholangitis: diagnosis, therapy, and long-term surveillance.Gastroenterology report · 2025Review
- Immunoglobulin G4 Cholangiopathy Masquerading as a Klatskin Tumor: An Interesting Case.Cureus · 2021Article
- Clinical and imaging findings suggestive of histopathological immunoglobulin G4-related disease: a single-center retrospective study.Clinical rheumatology · 2021Article
- Usefulness of ultrasonography to assess the response to steroidal therapy for the rare case of type 2b immunoglobulin G4-related sclerosing cholangitis without pancreatitis: A case report.World journal of clinical cases · 2020Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeTo compare the cross-sectional imaging findings of immunoglobulin G4-related sclerosing cholangiopathy (IgG4-SC) and cholangiocarcinoma (CCA).
methodsRetrospective search of radiology and pathology databases identified 24 patients with IgG4-SC and over 500 patients with CCA from January 2009 to December 2016. Patients with no pre-treatment imaging studies available on PACS, non-contrasted imaging only, presence of mass lesions, metastatic disease or biliary stents were excluded. 17 patients with IgG4-SC and a selected group of 20 (age and gender matched) patients with CCA were obtained. Images were blinded and independently reviewed by two radiologists. Differences in proportions and means between groups were analyzed using Fishers and Mann-Whitney tests, respectively.
resultsBoth readers identified a statistically significant difference in the presence of abrupt common bile duct narrowing between IgG4-SC and CCA (6.7% vs. 68.4%, p < 0.001; 33.3% vs. 75%, p = 0.019). No difference was seen in biliary wall thickening, wall enhancement, extrahepatic exclusive location of disease, or pancreatic duct dilation. Inter-observer variability was κ = 0.52. Total bilirubin and CA 19-9 were unable to differentiate between IgG4-SC and CCA. Serum IgG4 was positive in two of six IgG4-SC patients who were tested.
conclusionIgG4-SC and CCA share many clinical and imaging findings on CT and MRI. Abrupt bile duct cut sign strongly favors CCA. In the absence of this finding, IgG4-SC should be considered in the differential diagnosis in all cases of suspected extrahepatic CCA.
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