Combined MRI and diffuse-weighted imaging in evaluation of T-staging of gallbladder carcinoma and predicting histological grading

Abstract

Objective To study convention MRI compared with conventional MRI combined with diffusion-weighted imaging (DWI) in the evaluation of T-staging of gallbladder carcinoma, and to determine the relationship between the apparent diffusion coefficient (ADC) value and histological grading. Methods Fifty-one patients with gallbladder carcinoma confirmed by surgery and pathology were enrolled into this study. The T-staging was performed according to conventional MRI or with conventional MRI combined with DWI and the results were compared with pathological studies. Results The ADC value of tumor was measured to determine the correlation with T staging, pTNM staging and pathological tumor differentiation. For conventional MRI, the T-staging rate was 84.3%, which was consistent with the pathological T scoring (Kappa value 0.7580). After DWI, the T staging coincidence rate was 92.2% and the Kappa value was 0.8813. A comparison between conventional MRI versus conventional MRI combined with DWI T-staging compliance rates was performed using the Chi-square test (χ2=1.5111, P>0.05). The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation (r=-0.672, -0.749, 0.707, respectively, all P<0.05). Conclusions Conventional MRI helped in the diagnoses of T-staging in gallbladder cancer. MRI combined with DWI helped to improve the coincidence rate of T-staging. The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation. Conventional MRI combined with DWI better evaluated the T-staging of gallbladder cancer, and could better guide the choice of treatment methods. Key words: Gallbladder neoplasms; Neoplasm staging; Magnetic resonance imaging; Diffusion weighted imaging; Apparent diffusion coefficient