Correlation Between Morphological Patterns and Multidetector Computed Tomography (MDCT) Enhancement Patterns in Gallbladder Carcinoma With Locoregional Infiltration

TL;DR

This study examines how the shape and CT scan features of gallbladder cancer relate in Indian patients, focusing on infiltration patterns.

Contribution

The study identifies specific CT enhancement patterns correlated with gallbladder cancer infiltration in the Indian population.

Findings

Wall thickening in gallbladder cancer is significantly linked to infiltration into nearby organs and structures.

Portovenous hyperenhancement strongly correlates with non-contrast CT hypo-isoenhancement in gallbladder cancer.

Arterial hyperenhancement shows inverse relationships with certain morphological patterns like polypoidal growth.

Abstract

Objective: This study aimed to explore the correlation between morphological patterns and multidetector computed tomography (MDCT) enhancement patterns in gallbladder cancer with locoregional infiltration among the Indian population.

Methodology: This cross-sectional study was conducted across the pathology, surgery, and radiodiagnosis departments at Lady Hardinge Medical College, New Delhi. It focused on patients diagnosed with gallbladder disorders during the study period, identified through clinical examination or MDCT. Each patient underwent a fasting computed tomography (CT) scan using a Philips Brilliance 40-slice MDCT scanner. A neutral oral contrast, consisting of 1200 ml of water and 300 ml of 20% w/v mannitol, was administered. Additionally, for two patients suspected of gallbladder perforation extending to the pyloric duodenal area, a 2% non-ionic water-soluble contrast agent was used.

Results: The study found no statistically significant association between intraluminal polypoidal growth and other infiltration sites. However, wall thickening was significantly associated with various infiltration sites, including the liver, colon, bile ducts, and vascular structures. A strong positive correlation was observed between portovenous hyperenhancement and all examined morphological patterns, with the most notable correlations found with non-contrast CT (NCCT) hypo-isoenhancement. Conversely, arterial hyperenhancement showed an inverse relationship with some morphological patterns, with correlation coefficients of -0.60 for intraluminal polypoidal growth versus gallbladder wall thickening and mass replacement of the gallbladder versus intraluminal polypoidal growth.

Conclusion: Gallbladder cancer frequently leads to the replacement or damage of the gallbladder, with both focal and diffuse wall thickening being common findings. Hypo-isoenhancement was the most prevalent imaging pattern, while hyperenhancement was less common. Although intraluminal polypoidal growth did not significantly correlate with metastasis, wall thickening was significantly associated. These results emphasize the importance of specific imaging patterns in assessing the severity of gallbladder cancer and informing treatment strategies.