Contrast enhanced ultrasound versus multiphasic contrast enhanced computed tomography in evaluation of gallbladder lesions

Boddapati, Suresh Babu; Lal, Anupam; Gupta, Pankaj; Kalra, Naveen; Yadav, Thakur Deen; Gupta, Vikas; Dass, Ashim; Srinivasan, Radhika; Singhal, Manphool

doi:10.1007/s00261-021-03364-6

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…Additionally, CDFI can distinguish between benign and malignant disease by assessing blood supply status at the lesion site ( 6 , 24 ). Studies have indicated that most malignant lesions exhibit blood flow signals, whereas in benign lesions they are hardly observed ( 25 ). The pathological basis of gallbladder cancer with abundant blood flow is the abnormal proliferation of blood vessels within the tumor, thickening, and dilation of the gallbladder artery and its branches, and a tortuous and disorderly blood vessel shape, which in turn increases blood flow ( 25 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have indicated that most malignant lesions exhibit blood flow signals, whereas in benign lesions they are hardly observed ( 25 ). The pathological basis of gallbladder cancer with abundant blood flow is the abnormal proliferation of blood vessels within the tumor, thickening, and dilation of the gallbladder artery and its branches, and a tortuous and disorderly blood vessel shape, which in turn increases blood flow ( 25 , 26 ). Some researchers have reported elevated SE and SP in detecting blood flow signals, particularly in distinguishing early malignant lesions of the gallbladder from benign gallbladder bulge lesions.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic performance of the gallbladder reporting and data system combined with color doppler flow imaging for gallbladder cancer in the Asian population

Wang,

Lv,

2024

Front. Oncol.

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PurposeEvaluating the performance of the Gallbladder Reporting and Data System (GB-RADS) combined with Color Doppler Flow Imaging (CDFI) for the diagnosis of gallbladder wall thickening disease in an Asian population.MethodsIn this study, the lesions were classified and the actual incidence rate of malignant tumors was calculated for each GB-RADS category, following the guidelines provided by GB-RADS. To evaluate the diagnostic performance of GB-RADS and GB-RADS combined with CDFI, we plotted Receiver Operator Characteristic (ROC) curves. The sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy (AC) were also calculated. Inter-observer agreement (IRA) between the two observers was assessed using Kappa values.ResultsThe incidence of malignancy risk for GB-RADS 2, 3, 4, and 5 was 9%, 12.5%, 72.2%, and 100%. The AUC for GB-RADS was 0.855 (95% CI: 0.800-0.900), with a sensitivity of 82.5%, a specificity of 84.6%, and an accuracy of 83.8%. The AUC of GB-RADS combined with CDFI was 0.965 (95% CI: 0.930-0.985), with a sensitivity of 96.2%, a specificity of 94.6%, and an accuracy of 95.2%. The AUC, sensitivity, specificity, and accuracy of GB-RADS combined with CDFI for diagnosing gallbladder malignancy were higher than those of GB-RADS alone, and the differences were statistically significant (all P < 0.05). The IRA was excellent between the two observers (Kappa = 0.870).ConclusionsGB-RADS combined with CDFI demonstrated excellent diagnostic accuracy when it comes to distinguishing various diseases that caused gallbladder wall thickening in the Asian population, which has good clinical value and can improve the detection rate of malignant tumors in patients with gallbladder wall thickening.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of the gallbladder reporting and data system combined with color doppler flow imaging for gallbladder cancer in the Asian population

Wang,

Lv,

2024

Front. Oncol.

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“…Arterial hyper-enhancement is not per se diagnostic because it is also common in benign gallbladder lesions [32]. However, during the arterial phase, the detection of linear or irregular and branched vessels can suggest malignancy [13,136,137]. An early wash out (within 35 s) is strongly suggestive of malignancy [13,32,137].…”

Section: Sonographic Differentiation and Characterization Of Gbcmentioning

confidence: 99%

“…However, during the arterial phase, the detection of linear or irregular and branched vessels can suggest malignancy [13,136,137]. An early wash out (within 35 s) is strongly suggestive of malignancy [13,32,137]. In fact, about 91% of GBC and only 17% of benign lesions display wash-out within 35 s [134].…”

Section: Sonographic Differentiation and Characterization Of Gbcmentioning

confidence: 99%

New Developments in the Ultrasonography Diagnosis of Gallbladder Diseases

Mencarini,

Vestito,

Zagari

et al. 2024

Gastroenterology Insights

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Gallbladder diseases are very common, and their diagnosis is based on clinical–laboratory evaluation and imaging techniques. Considering the different imaging diagnostic tools, ultrasound (US) has the advantage of high accuracy combined with easy availability. Therefore, when a gallbladder disease is suspected, US can readily assist the clinician in the medical office or the emergency department. The high performance of US in the diagnosis of gallbladder diseases is mainly related to its anatomic location. The most frequent gallbladder pathological condition is gallstones disease, easily diagnosed via US examination. Acute cholecystitis (AC), a possible complication of gallstone disease, can be readily recognized due to its specific sonographic features. Additionally, a number of benign, borderline or malignant gallbladder lesions may be detected via US evaluation. The combined use of standard B-mode US and additional sonographic techniques, such as contrast-enhanced ultrasonography (CEUS), may provide a more detailed study of gallbladder lesions. Multiparametric US (combination of multiple sonographic tools) can improve the diagnostic yield during gallbladder examination.

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“…Contrast enhanced ultrasound (CEUS) can accurately detect microcirculation characteristics and has been used in the diagnosis of gallbladder diseases, such as sludge, gallbladder polyps and gallbladder cancer [ 5 , 17 , 18 ]. However, both wall-thickening type gallbladder cancer and GWT mimicking malignancy could present similar enhancement features, including inhomogeneous hyperenhancement intensity and destroyed serous layer on CEUS images, which poses great challenges for differential diagnosis [ 19 , 20 ].…”

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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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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Contrast enhanced ultrasound versus multiphasic contrast enhanced computed tomography in evaluation of gallbladder lesions

Cited by 8 publications

References 20 publications

Diagnostic performance of the gallbladder reporting and data system combined with color doppler flow imaging for gallbladder cancer in the Asian population

Diagnostic performance of the gallbladder reporting and data system combined with color doppler flow imaging for gallbladder cancer in the Asian population

New Developments in the Ultrasonography Diagnosis of Gallbladder Diseases

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

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