MRCP and EUS are diagnostically equivalent in detecting CBD stones among patients with intermediate risk, as shown in a landmark RCT. However, MRI-based imaging is power-intensive, requiring large infrastructure and long scan durations. EUS, a less energy-consuming and portable procedure, has the added advantage of enabling same-session ERCP, reducing the need for repeat procedures.
Age ≥18 years
Intermediate likelihood of CBD stone (per ESGE)
Undergoing either MRCP or EUS for evaluation
High or low likelihood category (per ESGE)
Undergoing both MRCP and EUS simultaneously
Contraindications to either modality