Details

Autor(en) / Beteiligte

• Kuipers, Hendrien
• Hoogwater, Frederik J.H.
• Holtman, Gea A.
• Slangen, Jules J.G.
• de Haas, Robbert J.
• de Boer, Marieke T.

Titel

Diagnostic performance of preoperative CT in differentiating between benign and malignant origin of suspicious gallbladder lesions

Ist Teil von

• European journal of radiology, 2021-05, Vol.138, p.109619-109619, Article 109619

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• •Sensitivity of CT for diagnosing gallbladder cancer is high, but specificity is relatively low.•A preoperative CT-based risk score for gallbladder cancer was developed, based on three predictors.•Use of the proposed CT-based risk score may facilitate differentiating between benign and malignant origin of suspicious gallbladder lesions and optimize treatment. To determine diagnostic performance of preoperative CT in differentiating between benign and malignant suspicious gallbladder lesions and to develop a preoperative risk score. All patients referred between January 2007 and September 2018 for suspicion of gallbladder cancer (GBC) or incidentally found GBC were retrospectively analyzed. Patients were excluded when preoperative CT or histopathologic examination was lacking. Two radiologists, blinded to histopathology results, independently reviewed CT images to differentiate benign disease from GBC. Multivariable analysis and internal validation were used to develop a risk score for GBC. Model discrimination, calibration, and diagnostic performance were assessed. In total, 118 patients with 39 malignant (33 %) and 79 benign (67 %) lesions were included. Sensitivity of CT for diagnosing GBC was 90 % (95 % confidence interval [CI]: 76–97). Specificity rates were 61 % (95 % CI: 49–72) and 59 % (95 % CI: 48–70). Three predictors of GBC (irregular lesion aspect, absence of fat stranding, and locoregional lymphadenopathy) were included in the risk score ranging from -1 to 4. Adequate performance was found (AUC: 0.79, calibration slope: 0.89). In patients allocated >0 points, the model showed higher performance in excluding GBC than the radiologists (sensitivity 92 % [95 % CI: 79–98]). Moreover, when allocated >3 points, the risk score was superior in diagnosing GBC (specificity 99 % [95 % CI: 93–100]). Sensitivity rates of CT for differentiation between benign and malignant gallbladder lesions are high, however specificity rates are relatively low. The proposed risk score may facilitate differentiation between benign and malignant suspicious gallbladder lesions.