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Han, H-S. (2022). Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography: an international expert consensus. Abdominal radiology (New York), 47(2), 554-565.

Babu Lal Meena and Sunil Taneja equally contributed as first authors. This study was registered with the Clinical Trial Registry of India (ctri.nic.in/Clinicaltrials/2019/ 05/019387). Declaration of conflict of interest: None. Author contributions: ST conceptualized the study design, interpreted the data, drafted the manuscript, and did critical revisions. PT conceptualized the study design, interpreted the data, and did critical revisions. BM contributed to the acquisition, analysis, and interpretation of

Objective To study the utility of 2D shear wave elastography (SWE) and ascertain cut‐off values of shear wave elasticity (SWe) to differentiate benign and malignant thickening of the gallbladder wall. Methods This study was a prospective study of patients with symptomatic gallstone disease (GSD, n = 51) and gallbladder cancer (GBC, n = 46) and controls without any biliary disease (n = 46). All the participants underwent 2D USG and SWE of the gallbladder. Grey‐scale ultrasound and SWE were done in the different regions in the gallbladder. Results The median age of the patients with GSD was 49 years (interquartile range [IQR]: 33–55), GBC was 55 years (IQR: 46–65), and controls was 37 years (IQR: 27–48.25). In patients with GBC, asymmetrical mural thickening was the predominant imaging pattern (n = 24, 52.2%). The mean SWe of the abnormal area in GBC (34.99 ± 17.77 kPa [n = 46]) was significantly higher than that of the uninvolved region (18.27 ± 8.12 kPa [n = 35]; P < .01). The mean SWe of the uninvolved region in GBC (18.27 ± 8.12 kPa [n = 35]) was also significantly higher (P < .01) than that of GSD (12.27 ± 4.13 kPa [n = 51]) and controls (10.52 ± 3.75 kPa [n = 46]). On ROC analysis, AUC of 0.927, at a cut‐off of 20 kPa, sensitivity was 91.3%, specificity was 83.5%, positive likelihood ratio was 5.54, and negative likelihood ratio was 0.10 to diagnose GBC. Conclusion The 2D SWE is a reliable adjunctive tool to grey‐scale USG in differentiating the malignant from benign gallbladder wall and may help to pick up early malignancy in GSD.

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Gallbladder cancer (GBC) has a high incidence in certain geographical regions. Morphologically, GBC presents as a mass replacing the gallbladder, a polypoidal lesion, or wall thickening. The incidence of preoperative diagnosis of wall thickening type of GBC is less well studied. The patterns of mural involvement and extramural spread are not well described in the literature. Additionally, wall thickening in the gallbladder does not always indicate malignancy and can be secondary to inflammatory or benign gallbladder diseases and extracholecystic causes and systemic pathologies. Objective reporting of gallbladder wall thickening will help us appreciate GBC's early features. In this review, we illustrate the imaging patterns of wall thickening type of GBC.

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An aberrant right subclavian artery (ARSA), also called as arteria lusoria, is one of the most common aortic arch anomalies. ARSA–esophageal fistula is a rare, life-threatening complication, with only 37 cases reported in literature. We describe a case of a young girl who developed acute episode of massive hematemesis after the recovery from novel coronavirus disease 2019 (COVID-19) pneumonia. Computed tomography (CT) angiography showed ARSA with retroesophageal course and active contrast leak in esophagus. Digital subtraction angiography confirmed the site of active contrast extravasation from the ARSA. However, the patient succumbed to hypovolemic shock even before the endovascular or surgical interventions could be done.