A Prospective Cross-Sectional Study of the Spectrum of Gallbladder Masses on Computed Tomography, Confirmed by Histopathological Examination at a Tertiary Care Centre in Eastern India.

Suruthi T I; Amit  Kumar; Umakant  Prasad; Bipin  Kumar

doi:10.51168/sjhrafrica.v6i6.1864

Authors

Dr. Suruthi T I Junior Resident, Department of Radio-diagnosis, IGIMS, Patna.
Dr. Amit Kumar M.D. Radio-diagnosis, Additional Professor, Department of Radio-diagnosis, IGIMS, PATNA
Dr. Umakant Prasad Additional Professor, Department of Radio-diagnosis, IGIMS, Patna.
Dr. Bipin Kumar Professor, Department of Pathology, IGIMS, Patna.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1864

Keywords:

Gallbladder carcinoma, Multi-Detector Computed Tomography (MDCT), Histopathology, Gallbladder mass, Diagnostic accuracy, Adenocarcinoma, Liver infiltration, Resectability, Contrast-enhanced CT

Abstract

Introduction:
Gallbladder carcinoma is the most common malignancy of the biliary tract and is often diagnosed at an advanced stage due to non-specific clinical symptoms. Early and accurate imaging is crucial for timely diagnosis and appropriate surgical planning. This study aimed to evaluate the structural and enhancement characteristics of gallbladder masses using Multi-Detector Computed Tomography (MDCT) and to correlate the imaging findings with histopathological results.

Methodology:

A prospective cross-sectional diagnostic study was conducted in the Department of Radio-diagnosis at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna. A total of 200 patients with clinically or sonographically suspected gallbladder cancer were enrolled between July 2021 and June 2022. All patients underwent contrast-enhanced MDCT using a Toshiba Aquilion 128-slice scanner. Imaging findings—including tumor morphology, local invasion, lymph node involvement, vascular encasement, and resectability—were recorded.

Results:

The mean age of the study population was 54.16 years, with a female predominance (70%). Common CT findings included focal irregular wall thickening (33.5%), sessile intraluminal polyps (27.5%), and masses replacing the gallbladder fossa (24.5%). Liver invasion was observed in 81% of cases, and lymph node metastases in 44.5%. Only 28% of patients had resectable disease at diagnosis. Histopathology revealed that moderately differentiated adenocarcinoma was the most frequent type (51.5%). MDCT demonstrated a sensitivity of 100%, specificity of 73.08%, and diagnostic accuracy of 96.5%.

Conclusion:

MDCT is a highly sensitive imaging modality for evaluating suspected gallbladder malignancies. It plays a critical role in tumor staging, assessing local extension, and determining operability. However, due to late-stage presentation, the majority of cases remain unresectable at the time of diagnosis.

Recommendation:

In endemic regions for gallbladder cancer, early screening through ultrasound followed by contrast-enhanced CT imaging is recommended to facilitate earlier detection and improve surgical outcomes.

Author Biographies

Dr. Suruthi T I, Junior Resident, Department of Radio-diagnosis, IGIMS, Patna.

Is a Junior Resident in the Department of Radio-diagnosis at IGIMS, Patna. She is currently pursuing her post-graduate training with a keen interest in abdominal and oncologic imaging. Her enthusiasm for learning and strong analytical skills played a key role in data collection and CT interpretation during the study.

Dr. Amit Kumar , M.D. Radio-diagnosis, Additional Professor, Department of Radio-diagnosis, IGIMS, PATNA

serves as an Additional Professor in the Department of Radio-diagnosis at IGIMS, Patna. With a solid background in diagnostic radiology, he brings significant experience in cross-sectional imaging. His leadership in academic research and hands-on clinical insight were valuable throughout the development of this study.

Dr. Umakant Prasad, Additional Professor, Department of Radio-diagnosis, IGIMS, Patna.

Is also an Additional Professor in the Department of Radio-diagnosis at IGIMS, Patna. He has extensive experience in advanced imaging techniques and is actively involved in postgraduate training. His contributions to image analysis and manuscript refinement reflect his commitment to research-based diagnostics.

Dr. Bipin Kumar, Professor, Department of Pathology, IGIMS, Patna.

Is a Professor in the Department of Pathology at IGIMS, Patna. He has a strong academic and diagnostic background in histopathology. His role in correlating imaging findings with histopathological outcomes was vital in confirming diagnoses and adding depth to the study’s conclusions.

References

Lazcano-Ponce, E. C., Miquel, J. F., Muñoz, N., Herrero, R., Ferrecio, C., Wistuba, I. I., Alonso de Ruiz, P., AristiUrista, G., & Nervi, F. (2001). Epidemiology and molecular pathology of gallbladder cancer. CA: A Cancer Journal for Clinicians, 51(6), 349-364. https://doi.org/10.3322/canjclin.51.6.349

Miller, G., & Jarnagin, W. R. (2008). Gallbladder carcinoma. European Journal of Surgical Oncology, 34(3), 306-312. https://doi.org/10.1016/j.ejso.2007.07.206

Batra, Y., Pal, S., Dutta, U., et al. (2005). Gallbladder cancer in India: A dismal picture. Journal of Gastroenterology and Hepatology, 20, 309-314. https://doi.org/10.1111/j.1440-1746.2005.03576.x

Mayo, S. C., Shore, A. D., Nathan, H., Edil, B., Wolfgang, C. L., Hirose, K., Herman, J., Schulick, R. D., Choti, M. A., & Pawlik, T. M. (2010). National trends in the management and survival of surgically managed gallbladder adenocarcinoma over 15 years: A population-based analysis. Journal of Gastrointestinal Surgery, 14(10), 1578-1591. https://doi.org/10.1007/s11605-010-1335-3

Perpetuo, M. D., et al. (1978). Natural history study of gallbladder cancer: A review of 36 years' experience at M. D. Anderson Hospital and Tumor Institute. Cancer, 42(1), 330-335.

https://doi.org/10.1002/1097-0142(197807)42:1<330::AID-CNCR2820420150>3.0.CO;2-F

Shukla, V. K., et al. (2006). Diagnostic value of serum CA242, CA 19-9, CA 15-3, and CA 125 in patients with carcinoma of the gallbladder. Tropical Gastroenterology, 27(4), 160-165.

Pandey, S. N., et al. (2006). Lipoprotein receptor-associated protein (LRPAP1) insertion/deletion polymorphism: Association with gallbladder cancer susceptibility. International Journal of Gastrointestinal Cancer, 37(4), 124-128. https://doi.org/10.1007/s12029-007-9002-y

Pandey, S. N., et al. (2007). Slow acetylator genotype of N-acetyl transferase 2 (NAT2) is associated with increased susceptibility to gallbladder cancer: The cancer risk is not modulated by gallstone disease. Cancer Biology & Therapy, 6(1), 91-96. https://doi.org/10.4161/cbt.6.1.3554

Singh, P., Kaur, N., & Kaur, M. (2017). Spectrum of CT findings in gall bladder carcinoma patients in the North Indian population. International Journal of Medical Research and Review, 5(5), 499-504. https://doi.org/10.17511/ijmrr.2017.i05.11

Grand, D. J., Horton, K. M., & Fishman, E. K. (2004). CT of the gallbladder: Spectrum of disease. American Journal of Roentgenology, 183(1), 163-170. https://doi.org/10.2214/ajr.183.1.1830163

Meilstrup, J. W., Hopper, K. D., & Thieme, G. A. (1991). Imaging of gallbladder variants. American Journal of Roentgenology, 157, 1205-1208. https://doi.org/10.2214/ajr.183.1.1830163

Duplicate of ref. 10 (same as Singh et al., 2017).

Gore, R. M., Yaghmai, V., Newmark, G. M., Berlin, J. W., & Miller, F. H. (2002). Imaging benign and malignant disease of the gallbladder. Radiologic Clinics of North America, 40(6), 1307-1323. https://doi.org/10.1016/S0033-8389(02)00042-8

Haaga, J. R., & Herbener, E. H. (2003). The gallbladder and biliary tract. In J. R. Haaga, C. F. Lanzieri & R. C. Gilkeson (Eds.), CT and MR imaging of the whole body (4th ed., pp. 1357-1360). Mosby.

Afifi, A. H., Abougabal, A. M., & Kasem, M. I. (2013). Role of multidetector computed tomography (MDCT) in diagnosis and staging of gall bladder carcinoma. The Egyptian Journal of Radiology and Nuclear Medicine, 44(1), 1-7. https://doi.org/10.1016/j.ejrnm.2012.12.006

George, R. A., Godara, S. C., & Dhaga, P. (2007). Computed tomographic findings in 50 cases of gall bladder carcinoma. Medical Journal Armed Forces India, 63(3), 215-219. https://doi.org/10.1016/S0377-1237(07)80137-7

Pandey, M., Shukla, R. C., Shukla, V. K., Gaharwar, S., & Maurya, B. N. (2012). Biological behavior and disease pattern of carcinoma gallbladder shown on 64-slice CT scanner: A hospital-based retrospective observational study and our experience. Indian Journal of Cancer, 49(3), 303. https://doi.org/10.4103/0019-509X.104496

Jindal, G., Singal, S., Birinder, N. A., Mittal, A., Mittal, S., & Singal, R. (2018). Role of multidetector computed tomography (MDCT) in evaluation of gallbladder malignancy and its pathological correlation in an Indian rural center. Maedica, 13(1), 55-60. https://doi.org/10.26574/maedica.2018.13.1.55