Diagnosis Options

How are Biliary System Cancers currently diagnosed?

There is a great need for new tumor markers for earlier detection and classification of complex molecular features required to guide therapy in this family of cancers. In addition to a complete medical history and physical examination, diagnostic procedures for Hepatobiliary cancers may include the following:

1Ultrasound (Sonography)

A diagnostic imaging technique which uses high-frequency sound waves to create an image of the internal organs.

2Computed tomography scan (CT)

A diagnostic imaging procedure using a combination of x-rays and computer technology to produce both horizontal and vertical cross-sectional images (often called slices), of the body.

3Magnetic resonance imaging (MRI)

A diagnostic imaging procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.


X-ray examination of the bile ducts using an intravenous (IV) dye (contrast).


A procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope.

6Endoscopic retrograde cholangiopancreatography (ERCP)

The procedure combines x-ray and the use of an endoscope. The scope is guided through the patient’s mouth and throat, then through the esophagus, stomach, and duodenum. The physician can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope and into the bile duct, and a dye is injected which will allow the internal organs to appear on an x-ray.

7Tumor Markers

Blood samples for tumor markers including alpha-fetoprotein (AFP), cancer antigen 19-9 (CA 19-9), and carcinoembryonic antigen (CEA) may be tested to guide the diagnostic evaluation but are limited by lack of specificity and sensitivity, and often are elevated only after tumors are far advanced..