Accuracy of CT in local staging of gallbladder carcinoma

Kim, B.S.; Ha, Hea Seon; I.-J., Lee; Kim, J.H.; Eun, Hyo Won; Bae, I.Y.; Kim, A.Y.; Kim, T.K.; Kim, M.H.; Lee, S.K.; Kang, Woo‐Hyoung

doi:10.1080/028418502127347475

Cited by 32 publications

(17 citation statements)

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“…Most common presentation is of a sub-hepatic mass replacing or obscuring the gall bladder (Fig.1) often with invasion of the adjacent liver [1][2][3]. This finding was seen in 28 (56%) of our cases with half of them in an inoperable stage of the disease, a feature reported in other studies also [7,8]. Liver invasion was easily detected on CT during the dual phase post-contrast images.…”

Section: Discussionsupporting

confidence: 61%

“…Yoshimitsu et al [7], reported an accuracy of 83-86% in diagnosing the local extent of carcinoma GB, but reported poor sensitivity for T1 lesions. Kim et al [8], have reported an overall accuracy of 71% in staging the T-factor of the TNM staging in their study of 100 consecutive cases, with accuracies varying from 79% for T1 & T2 , 46% for T3 and 73% for T4. The accuracy was lowest for thickened GB wall at 54% and highest for GB mass at 89%.…”

Section: Discussionmentioning

confidence: 96%

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Computed Tomographic Findings in 50 Cases of Gall Bladder Carcinoma

George

Godara²,

Dhagat

et al. 2007

Medical Journal Armed Forces India

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Original Article Introduction C arcinoma of the gall bladder (GB) is the fifth most common malignancy of the gastrointestinal tract and the commonest malignancy of the biliary tree [1,2]. It occurs primarily in the sixth to seventh decade of life and is four to five times more common in women [2,3]. Ultrasonography (USG) and computed tomography (CT) have revolutionized the diagnosis and management of carcinoma GB. Magnetic Resonance Imaging (MRI) is utilized only in inoperable cases with obstructive jaundice for delineation of the biliary tract anatomy in patients considered for palliative stenting [3].USG in patients of carcinoma GB has certain limitations such as interference by bowel gas, limited depth resolution and inadequate visualization of parts of the gallbladder in the region of posterior acoustic shadowing in the presence of calculi. CT scan overcomes these drawbacks and provides definite information regarding invasion of the tumour into the adjacent organs, distant metastasis, delineation of the biliary tree and portal vein involvement. We present our experience of CT findings in 50 histologically proven cases of carcinoma GB. Material and MethodsThis retrospective study reviewed CT examination findings in 50 histopathologically proven (from operative specimen or fine needle aspiration cytology) cases of carcinoma GB over a period of two years. The patients presented with a wide spectrum of complaints ranging from dyspepsia, abdominal pain to clinically palpable lump abdomen and obstructive jaundice. All the patients were subjected to helical CT scan examination on a GE HiSpeed CT/i scanner.The CT protocol of 5mm helical CT sections in the axial plane at table speed of 5 mm/sec (pitch 1.0) with kV 120 and mA 280 was used. Breath-hold periods varied from 10 to 16 seconds with intervening breathing time of 8 seconds. The CT scan technique employed in our patients included a preliminary survey scan of the abdomen from levels of the diaphragm to the iliac crest after orally administered one litre of iodinated contrast (800 ml administered 45 minutes prior to and 200ml given just prior to the scan) for opacification of bowel during customized breath-hold phase. This was followed by repeat evaluation of the abdomen during dynamic intravenous injection of 80 ml of non-ionic iodinated contrast medium (300 mg Iodine/ml) for studying the lesional enhancement and vascular structures. Intravenous contrast medium was administered at the rate of 2 ml/sec using a pressure injector at 150 psi using a scan delay of 30 seconds to commence imaging. Suspected cases of duodenal involvement were subjected to targeted area scanning with patient in right decubitus position. ResultsThere was definite female preponderance with male: female Computed Tomographic Findings in 50 Cases of Gall Bladder CarcinomaLt Col RA George * , Col SC Godara + , Lt Col P Dhagat # , Maj PP Som ** Abstract Background : A retrospective assessment of contrast enhanced computed tomography (CECT) scan findings in histopathologically proven cases of c...

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 96%

Computed Tomographic Findings in 50 Cases of Gall Bladder Carcinoma

George

Godara²,

Dhagat

et al. 2007

Medical Journal Armed Forces India

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“…Analysis of 1673 lesions demonstrated consistently high pooled Sen, Spe, PLR and DOR, but it also showed a lower NLR. According to the previous research, the overall sensitivity and accuracy of CEUS was found to be slightly higher than those of CT, PET/CT and MRI [30][31][32]. According to these results, CEUS can be used in clinical practice as an excellent diagnostic tool for evaluation and diagnosis of gallbladder carcinoma.…”

Section: Discussionmentioning

confidence: 90%

“…Conversely, previous research has suggested that many of these hindrances can be minimized by the use of ultrasonic contrast. Indeed, the high false-positive rate of contrast-enhanced ultrasound compared to CT may in fact represent its higher sensitivity in the detection of lesions [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of contrast-enhanced ultrasonography for the detection of gallbladder carcinoma

2016

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Aim: To systematically evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) for the detection of gallbladder carcinoma. Material and method: Relevant studies were identified searching PubMed, Embase, Elsevier, the CNKI (China National Knowledge Infrastructure) database and the Cochrane Trial Register searches until August 2015. Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic (ROC) curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in the diagnosis of gallbladder carcinoma. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: From 89 citations, 16 were included in the meta-analysis with a total of 1673 lesions. We detected heterogeneity between studies and evidence of publication bias. The methodological quality was moderate. The pooled weighted sensitivity with a corresponding 95% confidence interval (CI) was 0.92 (95%CI: 0.90, 0.94), the specificity was 0.91 (95%CI: 0.89, 0.93), the positive likelihood ratio was 10.01 (95%CI: 7.02, 14.29), the negative likelihood ratio was 0.10 (95%CI: 0.07, 0.14), and the diagnostic odds ratio was 123.02 (95%CI: 78.40, 193.03). The area under the ROC curve was 0.9689 (95%CI: 0.9376, 0.9879). Conclusions: CEUS is a reliable, non-invasive, and no-radiation-exposure imaging modality with a high sensitivity and specificity for detection of gallbladder carcinoma. Nonetheless, it should be applied cautiously, and large scale, well-designed trials are necessary to assess its clinical value.

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“…Kim et al [14] , have reported an overall accuracy of 71% in staging the T-factor of the TNM staging in their study of 100 consecutive cases, with accuracies varying from 79% for T1 & T2 , 46% for T3 and 73% for T4. The accuracy was lowest for thickened GB wall at 54% and highest for GB mass at 89%.…”

Section: Figurementioning

confidence: 99%