Bile Duct Cancer: Tests After Diagnosis

Ultrasound tests use sound waves to create images of the inside of your body. For an endoscopic ultrasound, the healthcare provider uses a thin, lighted tube called an endoscope. This tool has a small ultrasound device on the end that sends out the sound waves. The endoscope is put in through your mouth and moved down into your intestine near the bile ducts. This lets the healthcare provider get closer to the bile ducts to use ultrasound, which provides more detailed images. Your healthcare provider can use this test to see if cancer spread to nearby tissues.

A CT scan can help your healthcare provider see if bile duct cancer has spread to nearby lymph nodes or to other organs. A CT scan gives a better picture than an ultrasound. For the test, you lie still on a table as it slowly slides through the center of the ring-shaped CT scanner. The scanner sends beams of X-rays at your belly (abdomen). A computer uses the X-rays to create detailed 3-D pictures of your insides.

A CT scan doesn't hurt. You may be asked to hold your breath 1 or more times during the scan. In some cases, you may be asked to drink a contrast dye before the scan. This helps show more details on the images. You may be told to not eat anything after drinking the contrast dye and before having the scan. The contrast dye will slowly pass through your system and come out in your bowel movements.

An MRI uses magnets, radio waves, and a computer to make detailed images of the inside of your body. MRIs might be used to see if cancer has spread outside of your bile ducts. Like a CT scan, an MRI can show more detail than X-rays. A special type of MRI called magnetic resonance cholangiopancreatography (MRCP) gives clear and detailed images of the organs and tissues in the liver, gallbladder, bile ducts, and pancreas. Another test called MR angiography (MRA) is an MRI study of the blood vessels. It gives the best pictures of the blood vessels in an area. MRI may also be used instead of a CT scan for people who are allergic to contrast dye.

For this test, you lie still on a narrow table as it passes into a large, narrow tube. While inside the tube, radio waves are sent through your body into your abdomen. These are not X-rays. They don't hurt. A computer uses the data from the radio waves to create detailed pictures of the inside of your body. You may need more than 1 set of images. Each set may take 2 to 15 minutes. The whole scan may take an hour or more. There are loud, grating, and thumping noises during the scan. You may be given earplugs, headphones, or both to wear. If you are claustrophobic, you may be given a sedative before having this test. A 2-way intercom will let you talk with the people controlling the scanner at all times. 

For this test, a small amount of radioactive glucose (sugar) is injected into your blood through a vein. You then rest for an hour or so while the sugar is absorbed into the more active cells in your body. A scanner then creates pictures of the inside of the body and shows where the glucose is absorbed. These spots are called “hot spots.” Cancer cells absorb more glucose than normal cells, so this scan can help show where cancer may have spread in the body. This test can also be used to show the difference between active cancer cells and scar tissue. A PET scan may be combined with a CT scan to get more detailed information. This is called a PET-CT scan.