Diagnostic Accuracy of Contrast-Enhanced Computed Tomography (CECT) and Ultrasonography (USG) in Diagnosing Carcinoma Gallbladder keeping Histopathology the Gold Standard

Abstract

Objective: To evaluate the comparative role of ultrasonography and contrast-enhanced computed tomographyin diagnosis of carcinoma gallbladder. Early experience at a hepatobiliary unit in a tertiary care hospitalStudy Design: Cross sectional study.Place and Duration of Study: The study was carried out at the Hepatobiliary Unit of the Pak Emirates MilitaryHospital, Rawalpindi from July 2021 to June 2022.Materials and Methods: USG and CECT scans were used to assess the diagnostic accuracy of CarcinomaGallbladder. 30 patients, with an average age of 54 years, were part of this study. Patients were included in thestudy based on radiological findings pertinent to gallbladder cancer which include gallbladder fossa massreplacing gallbladder, focal/intraluminal/polypoidal gallbladder growth and asymmetrical/diffuse thickness ofgallbladder. All resected specimens were sent for histological investigation after the operation, histopathologyserving as the Gold standard.Results: On USG and CECT examination, 13.3% of the gallbladders were contracted and reduced in size, while70% were large and distended. CECT has a sensitivity and specificity of 96% and 80%, respectively, in identifyingGB carcinoma. USG scan had a sensitivity and specificity of 92% and 60%. There was a test of agreement isexcellent (Kappa value 0.819) between the two techniques, indicating that the two diagnostic modalities arenearly equivalent in terms of diagnosing carcinoma Gallbladder.Conclusion: The study findings indicate that both USG and CECT scans are ideal, non-invasive, safe imagingmodalities for diagnosing gallbladder carcinoma. CECT scan has an additional advantage in defining theextension of the disease and involvement of surrounding structures including lymph nodes and hepatoduodenal ligament.