Investigating the False Positive Rate in Diagnosing Indeterminate Biliary Stenosis

Abstract

Many bile duct strictures are classified as indeterminate biliary strictures (IDBS) due to the low sensitivity of primary diagnostic techniques and the inability to differentiate between malignant and benign. Therefore, since management approaches for malignant and benign cases are different, the increase in false-positive cases has posed a diagnostic challenge for specialists. False-positive cases diagnosed as malignancy can lead to incorrect disease management and result in additional costs, such as surgery, for the patient.  

The present study investigated the rate of false-positive cases in the diagnosis of IDBS and the related diagnostic challenges. The results of the evaluations showed that the use of primary techniques for diagnosing IDBS, such as endoscopic retrograde cholangiopancreatography (ERCP) and brushing, and computed tomography (CT) alone, was associated with a high false-positive rate (36.5%-47%). However, when the above techniques were combined with cholangiography, the false-positive rate decreased to 8.1%-15.1%. The results showed that the false positive rates in the diagnosis and evaluation of patiants with IDBS can vary in the range of 0%–47.7%, depending on the techniques used in patient assessment, operator expertise and skill, and patient condition.