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Preoperative differentiation between T1a and ≥T1b gallbladder cancer: combined interpretation of high-resolution ultrasound and multidetector-row computed tomography

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To determine the diagnostic value of combined interpretation of high-resolution ultrasound (HRUS) and multidetector-row computed tomography (MDCT) for preoperative differentiation between T1a and ≥T1b gallbladder (GB) cancer.

Methods

Eighty-seven patients with pathologically confirmed GB cancers (T1a, n = 15; ≥T1b, n = 72), who preoperatively underwent both HRUS and MDCT, were included in this retrospective study. Two reviewers independently determined the T-stages of the GB cancers on HRUS and MDCT using a five-point confidence scale (5, definitely T1a; 1, definitely ≥T1b). For individual modality interpretation, the lesions with scores ≥4 were classified as T1a, and, for combined modality interpretation, the lesions with all scores ≥4 in both modalities were classified as T1a. The McNemar test was used to compare diagnostic performance.

Results

The diagnostic accuracy of differentiation between T1a and ≥T1b GB cancer was higher using combined interpretation (90.8 % and 88.5 % for reviewers 1 and 2, respectively) than individual interpretation of HRUS (82.8 % and 83.9 %) or MDCT (74.7 % and 82.8 %) (P < 0.05, reviewer 1). Combined interpretations demonstrated 100 % specificity for both reviewers, which was significantly higher than individual interpretations (P < 0.05, both reviewers).

Conclusions

Combined HRUS and MDCT interpretation may improve the diagnostic accuracy and specificity for differentiating between T1a and ≥T1b GB cancers.

Key Points

• Differentiating between T1a and ≥T1b gallbladder cancer can help surgical planning.

• HRUS and MDCT are useful for local staging of gallbladder cancer.

• HRUS and MDCT may be synergistic for T-staging of gallbladder cancer.

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Abbreviations

HRUS:

High-resolution ultrasound

MDCT:

Multidetector-row computed tomography

GB:

Gallbladder

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Acknowledgements

The scientific guarantor of this publication is Jae Young Lee. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by the R&D program of MKE/KEIT (10033726, Ultrasound Multi-harmonic Imaging Techniques). No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea

    Ijin Joo, Jae Young Lee, Jee Hyun Baek, Jung Hoon Kim, Joon Koo Han & Byung Ihn Choi

  2. Department of Radiology, Konkuk University School of Medicine, Gwangjin-gu, Seoul, South Korea

    Hee Sun Park

  3. Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, South Seoul, 110-744, South Korea

    Jae Young Lee

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  1. Ijin Joo
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Correspondence to Jae Young Lee.

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Joo, I., Lee, J.Y., Baek, J.H. et al. Preoperative differentiation between T1a and ≥T1b gallbladder cancer: combined interpretation of high-resolution ultrasound and multidetector-row computed tomography. Eur Radiol 24, 1828–1834 (2014). https://doi.org/10.1007/s00330-014-3206-x

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  • DOI: https://doi.org/10.1007/s00330-014-3206-x

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