Fig. 8: Clinical evaluation of 4 representative patients diagnosed by the bile lipid classifier.

a Imaging of Patient 1 revealed nodules at the distal end of the common bile duct and dilation of the proximal duct. Cytological examination of the lower common bile duct revealed a relatively high number of bile duct epithelial cells. Most of these cells are well differentiated, although a small number exhibit slight disorganisation and mild heterogeneous hyperplasia. b Patient 2 presented with dilated intrahepatic bile ducts and localised stenosis at the lower end of the common bile duct. Postoperative pathology revealed localised intestinal epithelial hyperplasia with inflammatory cell infiltration in the biliary epithelium and localised pancreatic follicular atrophy. c, d Patients 3 and 4 exhibited similar imaging findings of marked dilatation of the intra- and extrahepatic bile ducts and stenosis of the middle and lower portions of the common bile duct. Postoperative pathology confirmed adenocarcinoma of the bile ducts. e Sex, age, CA19-9, and the bile lipid classifier-predicted probability of CCA in 4 patients.