Multiparametric MR imaging with diffusion-weighted, intravoxel incoherent motion, diffusion tensor, and dynamic contrast-enhanced perfusion sequences to assess gallbladder wall thickening: a prospective study based on surgical histopathology

Kalage, Daneshwari; Gupta, Pankaj; Gulati, Ajay; Yadav, Thakur Deen; Gupta, Vikas; Kaman, Lileswar; Nada, Ritambhra; Singh, Harjeet; Irrinki, Santosh; Gupta, Parikshaa; Das, Chandan Krushna; Dutta, Usha; Sandhu, Manavjit Singh

doi:10.1007/s00330-023-09455-w

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…Distinguishing wall-thickening type gallbladder cancer from GWT mimicking malignancy still poses a great challenge for physicians. The sensitivity of preoperative imaging diagnosis for wall-thickening type gallbladder cancer is less than 80% [ 12 , 16 ]. Therefore, discovering new imaging features through new imaging techniques is the key to improving the diagnostic performance of wall-thickening type gallbladder cancer.…”

Section: Discussionmentioning

confidence: 99%

“…However, the diagnostic performance of the GB-RADS score in distinguishing wall-thickening type gallbladder cancer from GWT mimicking malignancy needs to be further improved. There is also too much overlap of radiological imaging features (such as irregular gallbladder wall, discontinuous mucosa, enlarged lymph nodes and so on) to reliably differentiate wall-thickening type gallbladder cancer and GWT mimicking malignancy [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Value of high frame rate contrast enhanced ultrasound in gallbladder wall thickening in non-acute setting

Zhu,

Li,

Zhu

et al. 2024

Cancer Imaging

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Background Ultrasound (US) has been widely used in screening and differential diagnosis of gallbladder wall thickening (GWT). However, the sensitivity and specificity for diagnosing wall-thickening type gallbladder cancer are limited, leading to delayed treatment or overtreatment. We aim to explore the value of high frame rate contrast enhanced ultrasound (H-CEUS) in distinguishing wall-thickening type gallbladder cancer (malignant) from GWT mimicking malignancy (benign). Methods This retrospective study enrolled consecutive patients with non-acute GWT who underwent US and H-CEUS examination before cholecystectomy. Clinical information, US image and H-CEUS image characteristics between malignant and benign GWT were compared. The independent risk factors for malignant GWT on H-CEUS images were selected by multivariate logistic regression analysis. The diagnostic performance of H-CEUS in determining malignant GWT was compared with that of the gallbladder reporting and data system (GB-RADS) score. Results Forty-six patients included 30 benign GWTs and 16 malignant GWTs. Only mural layering and interface with liver on US images were significantly different between malignant and benign GWT (P < 0.05). Differences in enhancement direction, vascular morphology, serous layer continuity, wash-out time and mural layering in the venous phase of GWT on H-CEUS images were significant between malignant and benign GWT (P < 0.05). The sensitivity, specificity and accuracy of H-CEUS based on enhancement direction, vascular morphology and wash-out time in the diagnosis of malignant GWT were 93.75%, 90.00%, and 91.30%, respectively. However, the sensitivity, specificity and accuracy of the GB-RADS score were only 68.75%, 73.33% and 71.74%, respectively. The area under ROC curve (AUC) of H-CEUS was significantly higher than that of the GB-RADS score (AUC = 0.965 vs. 0.756). Conclusions H-CEUS can accurately detect enhancement direction, vascular morphology and wash-out time of GWT, with a higher diagnostic performance than the GB-RADS score in determining wall-thickening type gallbladder cancer. This study provides a novel imaging means with high accuracy for the diagnosis of wall-thickening type gallbladder cancer, thus may be better avoiding delayed treatment or overtreatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Value of high frame rate contrast enhanced ultrasound in gallbladder wall thickening in non-acute setting

Zhu,

Li,

Zhu

et al. 2024

Cancer Imaging

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“…The positive predictive value was relatively low, suggesting a part of the tumor without MVI had high levels of stiffness; this may reflect the fact that complex factors influence the stiffness of tissues. Other functional MRI techniques like intravoxel incoherent motion DWI imaging (16), arterial spin labelling (17) could be combined with MRE to increase the positive predictive value. We found that tumors without MVI were softer (with a lower stiffness) than the renal parenchyma, this may be due the heterogeneity of ccRCCs.…”

Section: Discussionmentioning

confidence: 99%

A diagnostic test of three-dimensional magnetic resonance elastography imaging for preoperative prediction of microvascular invasion in patients with T1 stage clear cell renal carcinoma

Zhang¹,

Wen²,

Chen³

et al. 2023

Transl Androl Urol

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Background: Detection of microvascular invasion (MVI) of kidney tumors is important for selecting the optimal therapeutic strategy. Currently, the prediction of MVI lacks an accurate imaging biomarker.This study evaluated the performance of three-dimensional (3D) magnetic resonance elastography (MRE) imaging in predicting microvascular invasion (MVI) of T1 stage clear cell renal carcinoma (ccRCC).Methods: In this prospective study, we conducted pre-surgical imaging with a clinical 3.0 T magnetic resonance imaging (MRI) system. Firstly, 83 consecutive patients were enrolled in this study. A 3D MRE stiffness map was generated and transferred to a post-processing workstation. Contrast-enhanced computed tomography (CT) was conducted to calculate the tumor enhancement ratio. The presence of MVI was evaluated by histopathological analysis and graded according to the risk stratification based upon the number and distribution. The mean stiffness and CT tumor enhancement ratio was calculated for tumors with or without MVI. The diagnostic performance [sensitivity, specificity, positive predictive value, negative predictive value, area under the curve (AUC)] and independent predicting factors for MVI were investigated.Results: Finally, A total of 80 patients (aged 46.7±13.2 years) were enrolled, including 22 cases of tumors with MVI. The mean MRE stiffness of kidney parenchyma and kidney tumors was 4.8±0.2 and 4.5±0.7 kPa, respectively. There was significant difference in the mean MRE stiffness between tumors with MVI (5.4±0.6 kPa) and tumors without MVI (4.1±0.3 kPa) (P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and the AUC for mean stiffness in the prediction of MVI were 100%, 75%, 63%, 96%, and 0.87 [95% confidence interval (CI): 0.72, 0.94], respectively. The corresponding values for the CT tumor enhancement ratio were 90%, 80%, 63%, 96%, and 0.88 (95% CI: 0.71, 0.93), respectively. The odds ratio (OR) value for MRE tumor stiffness and CT kidney tumor enhancement ratio in the prediction of MVI was 2.9 (95% CI: 1.8, 3.7) and 1.2 (95% CI: 1.0, 1.7), respectively (P>0.05).Conclusions: 3D MRE imaging has promising diagnostic performance for predicting MVI in T1 stage ccRCC, which may improve the reliability of surgical strategy selection with T1 stage ccRCC.

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“…MRI and magnetic resonance cholangiopancreatography (MRCP) are preferred to evaluate the longitudinal extent of perihilar CC, determination of local extent and intrahepatic metastases. A multiparametric MRI has been recently proposed to characterize gallbladder wall thickening ( 19 ). [ 18 F]-2-fluoro-2-deoxy- d -glucose–positron emission tomography (FDG PET) is not recommended for primary diagnosis of BTC ( 20 ).…”

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confidence: 99%

“…68G-FAPI PET has been reported to be superior to FDG-PET in detecting various primary tumors (22). In this Research Topic, Ouyang et al reported a systematic review comparing 19 F-FDG PET with 68 G-FAPI-04 PET in primary digestive system malignancy. They reviewed 15 studies comprising 383 patients and reported higher pooled sensitivity (98% vs. 73%) and specificity of 68Ga-FAPI-04 PET (0.81 vs. 0.77) compared to FDG PET for gastric, liver, biliary tract, and pancreatic cancers.…”

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confidence: 99%

Editorial: Role of imaging in biliary tract cancer: diagnosis, staging, response prediction and image-guided therapeutics

Gupta,

Kambadakone,

Sirohi

2024

Front. Oncol.

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Multiparametric MR imaging with diffusion-weighted, intravoxel incoherent motion, diffusion tensor, and dynamic contrast-enhanced perfusion sequences to assess gallbladder wall thickening: a prospective study based on surgical histopathology

Cited by 12 publications

References 33 publications

Value of high frame rate contrast enhanced ultrasound in gallbladder wall thickening in non-acute setting

Value of high frame rate contrast enhanced ultrasound in gallbladder wall thickening in non-acute setting

A diagnostic test of three-dimensional magnetic resonance elastography imaging for preoperative prediction of microvascular invasion in patients with T1 stage clear cell renal carcinoma

Editorial: Role of imaging in biliary tract cancer: diagnosis, staging, response prediction and image-guided therapeutics

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