Faculty of Medicine

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    CHOLANGIOCARCINOMA: CLINICAL AND LABORATORY TECHNIQUES WITH SPECIAL EMPHASIS ON IMAGING TECHNOLOGIES
    (Macedonian Association of Anatomists and Morphologists, 2026-02-23)
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    Bozhinovska, Biljana
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    Kostova, Masha
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    Bozhinovska Beaka, Gordana
    Cholangiocarcinoma is a rare and highly aggressive malignancy of the biliary epithelium, marked by considerable anatomical heterogeneity and a largely nonspecific clinical presentation, factors that frequently contribute to delayed diagnosis. The purpose of this study was to examine the demographic, clinical, laboratoryand imaging characteristics of patients with cholangiocarcinoma and to assess their relationship with imaging-based anatomical tumor classification.This retrospective study included 40 adult patients with histopathologically confirmed cholangiocarcinoma diagnosed in General Hospital “8th September” in Skopje, Republic of North Macedo-nia, between January 2022 and December 2025. Clinical presentation, hepatobiliary laboratory parameters, and imaging findings obtained using contrast-enhanced computed tomography, and most often magnetic res-onance imaging with magnetic resonance cholangiopancreatography were reviewed. Based on imaging find-ings, tumors were classified as intrahepatic, perihilar, or distal cholangiocarcinoma. The study population demonstrated a male predominance (62.5%), with a mean age at diagnosis of approximately 68 years. Perihilar cholangiocarcinoma was the most commonly identified type (55%), followed by distal (27.5%) and intrahepatic tumors (17.5%). Jaundice and pruritus occurred exclusively in patientswith extrahepatic disease, whereas all asymptomatic patients had intrahepatic tumors. Laboratory analysis revealed a marked cholestatic pattern in perihilar and distal cholangiocarcinoma, with substantially higher bilirubin, alkaline phosphatase, and gamma-glutamyl transferase levels compared with intrahepatic disease. Overall, these findings highlight the importance of anatomical tumor classification and support the integrated use of imaging(MR and MRCP), clinical assessment, and laboratory data in the diagnostic evalua-tion ofcholangiocarcinoma.
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    THE ROLE OF МR SPECTROSCOPY AND CONTRAST ENHANCED MRI IN PROSTATE CANCER DIAGNOSIS
    (Macedonian Association of Anatomists and Morphologists, 2025-11-25)
    Kostova, Masha
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    Bozhinovska, Biljana
    In patients with increased prostate-specific antigen, the next diagnostics tool is transrectal ultrasound-guided biopsy. The biopsy can cause pain, bleeding and infection. Multiparametric magnetic resonance imaging (mp MRI) as non-invasive diagnostics tool is used as a triage test to avoid biopsy, as well as to improve the diagnostics. The aim of this study was to examine the value of MR spectroscopy and dynamic post-contrast series in the diagnosis of prostate cancer. This cohort prospective study included 100 patients from CGH “September 8th” with increased levels of PSA. The MRI equipment used was Siemens Essenza 1,5T with body coil. The results obtained by MR spectroscopy analysis were correlated with the post-contrast series, whereby by mapping suspicious areas, patients underwent biopsy according to the PIRADS (prostate imaging and reporting data system) classification. Of the 100 patients, 96 were biopsied according to the PIRADS (prostate imaging and reporting data system) classification. The MRI results and pathohistological findings were then compared. On MR postcontrast series, a malignant lesion was detected in 52% of patients, in 33% of patients the lesion was suspicious for malignancy. On MR spectroscopy, a choline+creatinine/citrate ratio of 0.8 to 2 indicating a possible malignant lesion was confirmed in 33% of patients, this ratio was greater than 2 in 33% of patients, indicating a lesion highly suspicious for malignancy. MR spectroscopy combined with contrast enhanced MRI is a powerful tool for non-invasive differentiation of benign prostatic hyperplastic nodule and prostatitis from a malignant nodule.