Abstract
Here I summarize progress in research concerning diagnostic modalities for the biliary tract carcinoma to which I personally contributed. In 1981, I reported the first correct preoperative diagnosis of longitudinal extension using percutaneous transhepatic cholangioscopy (PTCS). I also reported diagnosis of biliary strictures by quantitative assessment using a derived hemoglobin index. Our group demonstrated usefulness of intraductal ultrasonography (IDUS) in 1989, and 3-dimensional IDUS in 1997, for precise diagnosis of cancer extension. In the early of 1980,s, I developed percutaneous transhepatic cholecystoscopy as an extension of PTCS. In 1992, I participated in the first trial of endoscopic magnetic resonance imaging (MRI). Improved, endoscopic MRI was able to depict the laminar structure of the gallbladder wall, and comparison could be made with diagnostic images obtained using endoscopic ultrasonography. We investigated the differential diagnosis of polypoid gallbladder lesions using contrast-enhanced ultrasonography beginning in 2001, and ongoing refinement of this modality is expected. Despite these various techniques, however, early diagnosis of biliary tract carcinoma remains insufficiently frequent, and further efforts are necessary.
