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MDCT in the Staging of Gallbladder Carcinoma

¹ Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, PGIMER, Sector 12, Chandigarh, India 160012.
² Department of General Surgery, Postgraduate Institute of Medical Education and Research, PGIMER, Chandigarh, India 160012.
³ Department of Histopathology, Postgraduate Institute of Medical Education and Research, PGIMER, Chandigarh, India 160012.

OBJECTIVE. The purpose of our study was to determine the utility of dual-phase MDCT with 3D reconstruction in the staging and resectability of gallbladder carcinoma.

SUBJECTS AND METHODS. Twenty-seven consecutive patients with suspected gallbladder carcinoma on clinical examination and routine sonography were prospectively analyzed with dual-phase MDCT. Of these patients, only 20 who underwent a laparotomy for extended cholecystectomy or a palliative surgery were included in the study. Three-dimensional volume-rendered reconstruction was used for evaluation of the vascular invasion and anatomy. The staging and resectability as determined on CT were compared with preoperative findings.

RESULTS. On the basis of the CT findings, eight tumors were resectable and 12 were unresectable. On surgery, 11 tumors were found to be resectable and the remaining were unresectable. Overstaging by CT occurred in three patients due to overassessment of duodenal infiltration. CT had a sensitivity of 72.7%, a specificity of 100%, and an accuracy of 85% for determining resectability of gallbladder carcinoma. For the diagnosis of hepatic and vascular invasion by the tumor, there was 100% correlation between CT and surgery. Vascular variations were found in six of the 11 patients who underwent radical cholecystectomy.

CONCLUSION. Dual-phase MDCT with 3D reconstruction is a comprehensive imaging technique for staging gallbladder carcinoma and determining the vascular road map before surgery.

Keywords: cancer • gallbladder • MDCT

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