Imaging Gallbladder Lesions: What Can Positron Emission Tomography/Computed Tomography Add to the Conventional Imaging Approach?

Sabaté‐Llobera, Aida; Reynés-Llompart, Gabriel; Mestres-Martí, Judit; Gracia‐Sánchez, Laura; Lladó, Laura; Serrano, Teresa; Ramos, Emilio; Cortés‐Romera, Montserrat

doi:10.1097/rct.0000000000001431

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…Previous studies have tried several modalities for differentiating between benign and malignant lesions. Sabaté-Llobera et al (16) compared the use of positron emission tomography/computed tomography (PET/CT) with 2-[18F]FDG to distinguish between benign and malignant pathology of the gallbladder compared with conventional imaging techniques (CE-CT or magnetic resonance imaging) and found that conventional imaging classified more studies as inconclusive compared with PET/CT (17.0% and 7.5%, respectively), although both procedures showed a similar accuracy. In this regard, the cost-to-benefit for conventional imaging might be superior due to its greater availability in less developed regions and lower cost.…”

Section: Discussionmentioning

confidence: 99%

Discrimination between benign and malignant gallbladder lesions on enhanced CT imaging using radiomics

Zhuang,

Feng,

Kong

et al. 2024

Acta Radiol

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Background Gallbladder cancer is a rare but aggressive malignancy that is often diagnosed at an advanced stage and is associated with poor outcomes. Purpose To develop a radiomics model to discriminate between benign and malignant gallbladder lesions using enhanced computed tomography (CT) imaging. Material and Methods All patients had a preoperative contrast-enhanced CT scan, which was independently analyzed by two radiologists. Regions of interest were manually delineated on portal venous phase images, and radiomics features were extracted. Feature selection was performed using mRMR and LASSO methods. The patients were randomly divided into training and test groups at a ratio of 7:3. Clinical and radiomics parameters were identified in the training group, three models were constructed, and the models’ prediction accuracy and ability were evaluated using AUC and calibration curves. Results In the training group, the AUCs of the clinical model and radiomics model were 0.914 and 0.968, and that of the nomogram model was 0.980, respectively. There were statistically significant differences in diagnostic accuracy between nomograms and radiomics features ( P <0.05). There was no significant difference in diagnostic accuracy between the nomograms and clinical features ( P >0.05) or between the clinical features and radiomics features ( P >0.05). In the testing group, the AUC of the clinical model and radiomics model were 0.904 and 0.941, and that of the nomogram model was 0.948, respectively. There was no significant difference in diagnostic accuracy between the three groups ( P >0.05). Conclusion It was suggested that radiomics analysis using enhanced CT imaging can effectively discriminate between benign and malignant gallbladder lesions.

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Section: Discussionmentioning

confidence: 99%

Discrimination between benign and malignant gallbladder lesions on enhanced CT imaging using radiomics

Zhuang,

Feng,

Kong

et al. 2024

Acta Radiol

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“…18 F-FDG PET-CT[ 54 , 55 ] or 18 F-FDG PET-MRI[ 28 ] must be performed before every intended major curative resection to exclude any occult metastatic lesion, which is not visible by the other imaging techniques, particularly in port-site metastases after laparoscopic cholecystectomy[ 29 ] and in ambiguous cases or at follow-up[ 12 , 31 , 56 ].…”

Section: Diagnosismentioning

confidence: 99%

New trends in diagnosis and management of gallbladder carcinoma

Pavlidis,

Galanis,

Pavlidis

2024

World J Gastrointest Oncol

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Gallbladder (GB) carcinoma, although relatively rare, is the most common biliary tree cholangiocarcinoma with aggressiveness and poor prognosis. It is closely associated with cholelithiasis and long-standing large (> 3 cm) gallstones in up to 90% of cases. The other main predisposing factors for GB carcinoma include molecular factors such as mutated genes, GB wall calcification (porcelain) or mainly mucosal microcalcifications, and GB polyps ≥ 1 cm in size. Diagnosis is made by ultrasound, computed tomography (CT), and, more precisely, magnetic resonance imaging (MRI). Preoperative staging is of great importance in decision-making regarding therapeutic management. Preoperative staging is based on MRI findings, the leading technique for liver metastasis imaging, enhanced three-phase CT angiography, or magnetic resonance angiography for major vessel assessment. It is also necessary to use positron emission tomography (PET)-CT or 18F-FDG PET-MRI to more accurately detect metastases and any other occult deposits with active metabolic uptake. Staging laparoscopy may detect dissemination not otherwise found in 20%-28.6% of cases. Multimodality treatment is needed, including surgical resection, targeted therapy by biological agents according to molecular testing gene mapping, chemotherapy, radiation therapy, and immunotherapy. It is of great importance to understand the updated guidelines and current treatment options. The extent of surgical intervention depends on the disease stage, ranging from simple cholecystectomy (T1a) to extended resections and including extended cholecystectomy (T1b), with wide lymph node resection in every case or IV-V segmentectomy (T2), hepatic trisegmentectomy or major hepatectomy accompanied by hepaticojejunostomy Roux-Y, and adjacent organ resection if necessary (T3). Laparoscopic or robotic surgery shows fewer postoperative complications and equivalent oncological outcomes when compared to open surgery, but much attention must be paid to avoiding injuries. In addition to surgery, novel targeted treatment along with immunotherapy and recent improvements in radiotherapy and chemotherapy (neoadjuvant-adjuvant capecitabine, cisplatin, gemcitabine) have yielded promising results even in inoperable cases calling for palliation (T4). Thus, individualized treatment must be applied.

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Imaging Gallbladder Lesions: What Can Positron Emission Tomography/Computed Tomography Add to the Conventional Imaging Approach?

Cited by 2 publications

References 33 publications

Discrimination between benign and malignant gallbladder lesions on enhanced CT imaging using radiomics

Discrimination between benign and malignant gallbladder lesions on enhanced CT imaging using radiomics

New trends in diagnosis and management of gallbladder carcinoma

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