Computed tomography derived imaging surrogates as pre-operative predictors of gall bladder pathologies in cases of cholecystic mural thickening

Mahesh Tiwari; Puneet; Tanya Singh; Ashish Verma

doi:10.18203/2320-6012.ijrms20263499

Authors

Mahesh Tiwari Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Puneet Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Tanya Singh Department of Surgery, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
Ashish Verma Department of Radiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263499

Keywords:

Gall bladder carcinoma, Mural thickening, Computed Tomography, Enhancement pattern

Abstract

Background: Diffuse or focal wall thickening wall is a common manifestation of most gall bladder pathologies. Identification of features to differentiate malignant from benign causes is hence of prime importance in clinical practice.

Methods: Contrast enhanced computed tomography (CT) scan was performed on 100 patients who revealed a gallbladder wall thickening (>5 mm) on screening sonography. The imaging features were charged with the intent of radiomic analysis and post-operative histopathologic correlation was done.

Results: The average wall thickness was 22.28±12.51 mm in malignancies and 13.5±6.6 mm in benign conditions with the difference being highly significant (p<0.05). The gallbladder wall thickening was a common feature (76.2%) in benign group while wall thickening with associated focal mass lesion was common (59.5%) in malignant group. Morphologically inhomogeneous lesions were more prone to develop malignancy (53%) compared to benign lesions in which homogeneous wall thickening (52.4%) was common. Type I (39.2%) and type II (39.2%) was seen in malignant conditions, while type I pattern was also seen in xanthogranulomatous cholecystitis (66.7%). Type V was common in benign cases (23.8%).

Conclusions: Amongst the charted radiomic features wall thickening and pattern of wall thickening were the most significant with sensitivity and specificity of 59.49% and 76.19% respectively. The next most common feature was pattern of enhancement on post contrast CT scan.

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