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Radio-pathological Correlation of 18F-FDG PET in Characterizing Gallbladder Wall Thickening

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Abstract

Aim

Thick-walled gallbladder is difficult to characterize on conventional imaging. 18F-FDG PET was used to differentiate benign and malignant wall thickness and compared with histopathology.

Methods

Thirty patients with gallbladder (GB) wall thickening (focal > 4 mm and diffuse > 7 mm), underwents uspected on  ultrasound, or CT scan, and underwent 18F-FDG PET. Histopathology of the specimen was compared with imaging findings.

Results

The mean age was 48.22 ± 31.33 years with a M:F 1:4 ratio. Twenty patients had diffuse and 10 had focal thickening. On 18F-FDG PET, lesion was benign in 12, malignant in 13, and indeterminate in 5. Histopathology was malignancy in 12; benign in 18-chronic cholecystitis in 11, xanthogranulomatous in 4, IgG4 related in 2, and polyp in 1. The mean GB wall thickness was 7.79 ± 3.59 mm (10.34 malignant and 6.10 in benign, p = 0.001). At a cutoff of 8.5 mm, the sensitivity and specificity of detecting malignancy was 94% and 67%. The mean SUV uptake was 7.46 (benign 4.51, malignant 14.26, p = 0.0102). At a cutoff of 5.95, the sensitivity and specificity of detecting malignancy was 92% and 79%. For 18F-FDG PET, overall sensitivity was 91%, specificity 79%, PPV 77%, NPV 92%, and diagnostic accuracy was 84%.

Conclusion

18F-FDG PET is a reliable method of differentiation between benign and malignant thickening of the gallbladder particularly when wall thickness and SUV value is taken into account.

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Authors and Affiliations

  1. Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Vikas Gupta, K. S. Vishnu, Thakur D. Yadav, Yashwant R. Sakaray & Santosh Irrinki

  2. Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    B. R. Mittal

  3. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    N. Kalra

  4. Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    K. Vaiphei

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  1. Vikas Gupta
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  2. K. S. Vishnu
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  3. Thakur D. Yadav
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Contributions

VG, TDY: concept and idea; KSV: clinical data collection; NK: Radiological data, BRM: PET-CT data; KV: Pathological data, VG, YRS, SI: drafting and correction.

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Correspondence to Vikas Gupta.

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Gupta, V., Vishnu, K.S., Yadav, T.D. et al. Radio-pathological Correlation of 18F-FDG PET in Characterizing Gallbladder Wall Thickening. J Gastrointest Canc 50, 901–906 (2019). https://doi.org/10.1007/s12029-018-0176-2

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  • DOI: https://doi.org/10.1007/s12029-018-0176-2

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