Gallbladder carcinoma: color Doppler sonography

Komatsuda, Tomoya; Ishida, Hideaki; Konno, Kunihiko; Hamashima, Y.; Naganuma, Hiroko; Sato, Michiko; Watanabe, Sumio

doi:10.1007/s002619910044

Cited by 50 publications

(29 citation statements)

References 5 publications

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“…He also proposed that benign tumors have a lower percentage of detectable blood flow compared with malignant tumors, as an additional differentiation criterion between them. Measurement of the flow rate is also important, with a higher rate for malignant than benign tumors [37]. Hayakawa et al [40] obtained a sensitivity of 0 and specificity of 0.96 for diagnosis of malignant tumor using a cutoff point of 30 cm/s.…”

Section: Ultrasound In Gbcmentioning

confidence: 98%

“…Several publications [37][38][39] have underlined its utility in the differential diagnosis of carcinoma with other benign inflammatory or polypoid lesions and with tumescent biliary sludge. Komatsuda et al [37] suggested that detection of flow within the lesion supports the diagnosis of carcinoma versus biliary sludge (Se: 0.84; Sp: 0.80). However, the absence of flow does not completely rule out a tumor.…”

Section: Ultrasound In Gbcmentioning

confidence: 99%

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Application of modern imaging methods in diagnosis of gallbladder cancer

Rodrı́guez-Fernández

Gómez-Río

Medina-Benítez

et al. 2006

Journal of Surgical Oncology

104

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The poor prognosis of gallbladder cancer (GBC) is related to its dissemination capacity and usually late diagnosis due to its non-specific clinical appearance. Recent improvements in hepatobiliary surgery have underlined the importance of an early specific diagnosis, which requires a multidisciplinary approach and, when possible, specialized equipment. The first step in an early diagnosis is to identify patients in the appropriate epidemiological setting (e.g., incidental finding, chronic cholecystitis) for the correct interpretation of test results. It is desirable to enhance the sensitivity of the initial ultrasound (US) examination by use of the appropriate technology in skilled specialist hands. When GBC is suggested by US findings, FDG-PET can be considered complementary to establish the benign/malignant nature of the lesion and to obtain a primary staging study. If GBC is confirmed, thin slice spiral CT can contribute valuable information on local spread. In this regard, recent hybrid PET-CT systems provide structural and functional information simultaneously and may offer early and accurate T, N, and M staging with an improved specificity.

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Section: Ultrasound In Gbcmentioning

confidence: 98%

Section: Ultrasound In Gbcmentioning

confidence: 99%

Application of modern imaging methods in diagnosis of gallbladder cancer

Rodrı́guez-Fernández

Gómez-Río

Medina-Benítez

et al. 2006

Journal of Surgical Oncology

104

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“…A high flow rate of 30 cm/s had a sensitivity of 96%, while a cut off of 20 cm/s had a sensitivity of 72% and specificity of 66% to identify GBC. 20,21 Using EUS, the independent predictors of neoplastic polyps were larger polyp size, larger diameter, height/width ratio of <0.8, presence of heterogenous internal echo pattern, and absence of hyperechoic spotting on EUS were independent predictors for the presence of a neoplastic polyp. A composite EUS score of >12 based on maximum diameter in millimetres, internal echo pattern score and hyperechoic spot had a sensitivity, specificity, and accuracy for the risk of neoplastic polyps of 78%, 83% and 83% respectively.…”

mentioning

confidence: 99%

Gallbladder polyps: How to pick up the sinister ones

Dutta

Poornachandra

2009

J of Gastro and Hepatol

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“…The presence of increased vascularity within a gallbladder polyp suggests malignancy [11,12]. However, the presence of increased vascularity within the gallbladder wall has not been evaluated on power Doppler evaluation to differentiate between malignancy and chronic cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

Radiological evaluation of the enhancement patterns of thickened gallbladder wall to differentiate benign from malignancy

Kalra¹

2017

JGPLD

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commonly seen in women (two to three times) than in men and its incidence steadily increases with age [1]. Thickening of gallbladder wall is a commonly detected finding on different imaging modalities. The finding itself is however non-specific and can result from multiple pathologic conditions including surgical and non-surgical disorders. The least common presentation of gallbladder carcinoma is focal or diffuse thickening of the gallbladder wall, and is difficult to diagnose, particularly in the early stages. Considering the non-specific nature of the clinical manifestations, which are indistinguishable from chronic cholecystitis, it is important to have an imaging tool for early detection of gallbladder cancer, because the management and prognosis of gallbladder carcinoma differs from benign etiologies. It is also well recognized that early detection, although a mere coincidental rarity, improves survival [2][3][4]. On the other hand, misinterpretation of diffuse gallbladder wall thickening in patients who do not have primarily gallbladder disease can lead to unnecessary cholecystectomy. This situation calls for an improved imaging strategy to differentiate between benign and malignant causes of thickened gall bladder wall in order to select patients for aggressive therapeutic efforts [4].Computed tomography to differentiate cholecystitis from carcinoma has been evaluated as early as in 1984 [5], however the signs reported to be useful included detecting a focal mass, biliary obstruction at porta hepatis, invasion of liver and nodal metastases. Yun et al [6] evaluated different patterns of enhancement thickened gallbladder wall in arterial and venous phases and found them helpful in differentiating gallbladder carcinoma from chronic cholecystitis when using two-phase helical CT. The authors opined that two-phase spiral CT was more useful than single phase CT for differentiating between these two disease entities. Another retrospective study by Kim et al [7] aimed to differentiate the gallbladder Abstract Objective: To evaluate the enhancement patterns of thickened gallbladder wall on MDCT and vascularity of gallbladder wall on Doppler Ultrasound, and to correlate imaging findings with pathological diagnosis in malignant and non-malignant conditions. Methods:In this institute's ethics committee approved prospective study, 15 patients with gallbladder wall thickening (>3mm on ultrasonography) underwent contrast enhanced twophase MDCT of abdomen and Doppler examination for gallbladder. The gallbladder wall attenuation value on CT was measured by drawing Region of Interest and compared to liver parenchymal attenuation. Enhancement patterns of gallbladder wall on CT were analysed. The findings were correlated with pathological diagnosis. Results:The presence of layered pattern of enhancement of gallbladder wall was seen more in carcinoma (85.7%). Lack of layered pattern correlated with benign nature. The difference was statistically significant (p=0.005). The finding of hyper-attenuation of gallbladder wall to th...

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Gallbladder carcinoma: color Doppler sonography

Cited by 50 publications

References 5 publications

Application of modern imaging methods in diagnosis of gallbladder cancer

Application of modern imaging methods in diagnosis of gallbladder cancer

Gallbladder polyps: How to pick up the sinister ones

Radiological evaluation of the enhancement patterns of thickened gallbladder wall to differentiate benign from malignancy

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