Important ultrasonography and CT findings and prognostic factors of incidentally detected gallbladder cancer

Abstract

Aims: To evaluate important imaging findings and prognostic factors of incidentally detected gallbladder cancer (IDGC). Materials and methods: Patients with surgically proven IDGC (n=85) and benign GB diseases (n=100) were retrospectively enrolled. All patients had preoperative CT and eighty-two patients had US images. Two radiologists independently assessed image findings and analyzed findings suggestive of IDGC and recurrence after surgery. Univariate and multivariate analyses were performed to identify significant predictors for IDGC and recurrence.Results: 87% (74/85) of IDGC belonged to early cancer. On US, mucosal irregularity (odds ratio (OR), 26.29; 95% confidence interval (CI), 2.66-259.42; p=0.005) was a significant predictor of IDGC. Enhancement pattern of wall (OR, 7.78; 95% CI, 2.84-21.39; p<0.001), and maximum wall thickness (OR, 1.31; 95% CI, 1.11-1.55; p=0.002) were significant predictors of IDGC on CT. Twenty-two patients showed recurrence. For clinical factors, T-, N-stage were associated with recurrence (p<0.001). For imaging, focal wall thickening (OR, 8.74; 95% CI, 1.13-67.49, p=0.038) on US and lymph node enlargement (LNE) (OR, 8.93; 95% CI, 1.44-55.19, p=0.018) on CT were significant predictors of recurrence.Conclusion: Image findings are useful to predict IDGC using mucosal disruption, maximum wall thickness, enhancement pattern of wall. In addition, focal wall thickening and LNE were useful for predicting recurrence.