Virtual CT cholangioscopy: Comparison with fiberoptic cholangioscopy

Background and Study Aims: No studies comparing virtual computed tomography (CT) cholangioscopy of the common bile duct compared with fiberoptic chola ngioscopy are available. The aim of our study was to evaluate the feasibili ty of virtual CT cholangioscopy of the common bile duct. Patients and Methods: The study population comprised 52 patients (25 women, 27 men; mean age 56.5, range 32-81) with biliopancreatic disorders. Endosc opic images were produced by a volume-rendering method and a perspective pr ojection. The ability to detect the endoluminal view and abnormalities of t he common bile duct by virtual CT cholangioscopy and fiberoptic cholangiosc opy was evaluated. Results: Except for two cases (4 %), virtual CT cholangioscopy revealed exc ellent and moderate endoluminal visualization. There was no significant dif ference be-tween the techniques (virtual CT cholangioscopy vs. fiberotic ch olangioscopy: excellent, 73 % vs. 85 %, P=0.149; moderate 23% vs. 15% (P=0. 319); poor, 4 % vs. 0 %, P = 0.153). Virtual CT cholangioscopy revealed no significantly different ability to detect stenosis and obstruction of the c ommon bile duct, compared with fiberoptic cholangioscopy. However, the abil ity of virtual CT cholangioscopy to detect minute papillary tumors (virtual CT cholangioscopy 30 % vs. fiberoptic cholangioscopy 100%, P=0.001) and st ones smaller than 5 mm (virtual CT cholangioscopy 25 % vs. fiberoptic chola ngioscopy 100%; P=0.002 was significantly less than that of fiberoptic chol angioscopy. Conclusions: Virtual CT cholangioscopy cannot replace fiberoptic cholangios copy completely. However, the use of this technique, instead of fiberoptic cholangioscopy, may be feasible for following up patients after biliary int ervention.