Locally advanced gallbladder cancer: a review of the criteria and role of imaging

Gupta, Pankaj; Meghashyam, Kesha; Marodia, Yashi; Gupta, Vikas; Basher, Rajender Kumar; Das, Chandan Krushna; Yadav, Thakur Deen; Irrinki, Santhosh; Nada, Ritambhra; Dutta, Usha

doi:10.1007/s00261-020-02756-4

Cited by 25 publications

(16 citation statements)

References 48 publications

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“…Cross sectional imaging provides comprehensive anatomical information allowing assessment of staging and resectability [8,9]. Despite the advances in imaging techniques, characterization of gallbladder lesions poses a significant challenge [10][11][12]. Incidental GBC identified during or after surgery accounts for 15-30% of all GBCs [4].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography texture-based radiomics analysis in gallbladder cancer: initial experience

Gupta¹,

Rana²,

Ganeshan³

et al. 2021

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Aim of the study:To investigate computed tomography (CT) texture parameters in suspected gallbladder cancer (GBC) and assess its utility in predicting histopathological grade and overall survival. Material and methods: This retrospective pilot study included consecutive patients with clinically suspected GBC. CT images, clinical, and histological or cytological data were retrieved from the database. CT images were reviewed by two radiologists. A single axial CT section in the portal venous phase was selected for texture analysis. Radiomic feature extraction was done using commercially available research software. Results: Thirty-eight patients (31 females, mean age 53.1 years) were included. Malignancy was confirmed in 29 patients in histopathology or cytology analysis, and the rest had no features of malignancy. Exophytic gallbladder mass with associated gallbladder wall thickening was present in 22 (58%) patients. Lymph nodal, liver, and omental metastases were present in 10, 1, and 3 patients, respectively. The mean overall survival was 9.7 months. There were significant differences in mean and kurtosis at medium texture scales to differentiate moderately differentiated and poorly differentiated adenocarcinoma (p < 0.05). The only texture parameter that was significantly associated with survival was kurtosis (p = 0.020) at medium texture scales. In multivariate analysis, factors found to be significantly associated with length of overall survival were mean number of positive pixels (p = 0.02), skewness (p = -0.046), kurtosis (0.018), and standard deviation (p = 0.045). Conclusions: Our preliminary results highlight the potential utility of CT texture-based radiomics analysis in patients with GBC. Medium texture scale parameters including both mean and kurtosis, or kurtosis alone, may help predict the histological grade and survival, respectively.

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Section: Introductionmentioning

confidence: 99%

Computed tomography texture-based radiomics analysis in gallbladder cancer: initial experience

Gupta¹,

Rana²,

Ganeshan³

et al. 2021

ceh

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“…Patient underwent radical cholecystectomy with albeit surprisingly no infiltration and preserved planes. In the systematic review by Gupta et al it was found that there is an increase possibility of R0 resection by 15–86% after NACT in locally advanced (T3, T4) Ca GB [ 29 ]. 5-Flourouracil and Gemcitabine based chemotherapies have demonstrated benefit in patients with positive margins after resection, nodal positive disease and T3, T4 diseases [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The giant resectable carcinoma of gall bladder—a case report

et al. 2021

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Background Gall bladder cancer (GBC) is the fifth most common malignancy in the gastrointestinal system and the most common malignancy of the biliary system. GBC is a very aggressive malignancy having a 5 year survival rate of 19%. Giant Gall Bladder (GGB) is an uncommon condition that can result from cholelithiasis or chronic cholecystitis and rarely with malignancy. Case report A 65 year old lady presented with vague abdominal pain for 12 years and right abdominal lump of size 20 × 8 cms was found on examination. CT scan showed a circumferentially irregularly thickened wall (2.5 cm) of gall bladder indicative of malignancy. Per-operatively a GB of size 24 × 9 cm was noted and patient underwent radical cholecystectomy. It was surprise to find such a giant malignant GB with preserved planes. Histopathology, it was well differentiated adenocarcinoma of gall bladder of Stage II (T2a N0 M0). Discussion It is known that mucocoele of GB can attain large size, however chronic cholecystitis will lead to a shrunken gall bladder rather than an enlarged one. A malignant GB of such size and resectable is rare without any lymph node involvement or liver infiltration. Few cases of giant benign gall bladder have been reported in literature, however this appears to be the largest resectable gall bladder carcinoma reported till date as per indexed literature. Conclusion Giant GB is an uncommon finding. They are mostly benign, however malignant cases can occur. Radiological findings may suggest features of malignancy and define extent of disease. Prognosis depends on stage of disease and resectability, irrespective of size.

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“…The common causes include cholangiocarcinoma, pancreatic cancer, metastatic disease, and carcinoma gallbladder [2]. Carcinoma gallbladder particularly has a poor prognosis [9,10]. Severe cholangitis occurs as a complication of biliary obstruction from both benign and malignant conditions [1].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and safety of bedside percutaneous biliary drainage in patients with severe cholangitis

et al. 2020

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Purpose To evaluate the safety and feasibility of bedside percutaneous transhepatic biliary drainage (PTBD) as a salvage procedure in patients with severe cholangitis in the intensive care unit (ICU). Methods This retrospective study evaluated records of consecutive patients with severe cholangitis who were admitted in the ICU. Bedside PTBD was performed using ultrasound guidance. The level and cause of biliary obstruction were recorded. The technical success of the procedure and complications were recorded. Results Ten patients (six males, mean age 53.8 years) underwent bedside PTBD. Six patients had distal common bile duct blockade [periampullary carcinoma ( n = 2), carcinoma pancreas ( n = 2), choledocholithiasis ( n = 1), and benign stricture ( n = 1)]. Four patients had malignant hilar stricture [cholangiocarcinoma ( n = 3) and carcinoma gallbladder ( n = 1)]. Technical success was achieved in all. One patient underwent bilateral PTBD. Left and right PTBD were performed in 5 and 4 patients, respectively. There were no major complications. Transient hemobilia occurred in two patients. Conclusion Bedside PTBD is safe and technically feasible. Prospective studies are required to establish this procedure into routine clinical practice.

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Locally advanced gallbladder cancer: a review of the criteria and role of imaging

Cited by 25 publications

References 48 publications

Computed tomography texture-based radiomics analysis in gallbladder cancer: initial experience

Computed tomography texture-based radiomics analysis in gallbladder cancer: initial experience

The giant resectable carcinoma of gall bladder—a case report

Feasibility and safety of bedside percutaneous biliary drainage in patients with severe cholangitis

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