Dual-energy CT in differentiating benign gallbladder wall thickening from wall thickening type of gallbladder cancer

期刊论文
发表日期：

2024年7月9日

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Kakivaya Pavankumar Reddy,
Pankaj Gupta,
Ajay Gulati,
Tarvinder Singh,
Daneshwari Kalage,
Harjeet Singh,
Lileswar Kaman,
Thakur Deen Yadav,
Santosh Irrinki,
Atul Saroch,
Vikas Gupta,
Uma Nahar Saikia,
Ritambhra Nada,
Parikshaa Gupta,
Radhika Srinivasan,
Usha Dutta

摘要

Objective

To evaluate the performance of dual-energy computed tomography (DECT) in differentiating non-acute benign from malignant gallbladder wall thickening (GBWT).

Methods

This prospective study comprised consecutive adults with GBWT who underwent late arterial phase (LAP) and portal venous phase (PVP) DECT between January 2022 and May 2023. The final diagnosis was based on histopathology or 3-6 months follow-up imaging. DECT images in LAP and PVP were assessed independently by two radiologists. The demographic, qualitative, and quantitative parameters were compared between two groups Multivariate logistic regression was performed to determine the association between the aforementioned factors and malignant GBWT.

Results

Seventy-five patients (mean age 56 ± 12.8 years, 46 females) were included. Forty-two patients had benign, and 33 had malignant GBWT. In the overall group, female gender (p = 0.018), lymphadenopathy (p = 0.011), and omental nodules (p = 0.044) were significantly associated with malignant GBWT. None of the DECT features differed significantly between benign and malignant GBWT in overall group. In the xanthogranulomatous cholecystitis (XGC, n = 9) vs. gallbladder cancer (GBC) (n = 33) subgroup, mean attenuation value at 140 keV LAP VMI was significantly associated with malignant GBWT [p = 0.023, area under curve 0.759 (95%CI 0.599–0.919)].

Conclusion

DECT-generated quantitative parameters do not add value in differentiating non-acute benign from malignant GBWT. However, DECT may have a role in differentiating XGC from GBC in a selected subgroup of patients. Further, larger studies may be necessary to confirm these findings.

Clinical relevance statement

In patients with non-acute gallbladder wall thickening in whom there is suspicion of xanthogranulomatous cholecystitis (XGC), DECT findings may allow differentiation of XGC from wall thickening type of gallbladder cancer.

Key Points

Differentiation of benign and malignant gallbladder wall thickening (GBWT) at CT is challenging.

Quantitative dual energy CT (DECT) features do not provide additional value in differentiating benign and malignant GBWT.

DECT may be helpful in a subgroup of patients to differentiate xanthogranulomatous cholecystitis from gallbladder cancer.