Abstract：
OBJECTIVE: To evaluate the performance of dual-energy computed tomography (DECT) in differentiating non-acute benign from malignant gallbladder wall thickening (GBWT).
METHODS: This prospective study comprised consecutive adults with GBWT who underwent late arterial phase (LAP) and portal venous phase (PVP) DECT between January 2022 and May 2023. The final diagnosis was based on histopathology or 3-6 months follow-up imaging. DECT images in LAP and PVP were assessed independently by two radiologists. The demographic, qualitative, and quantitative parameters were compared between two groups Multivariate logistic regression was performed to determine the association between the aforementioned factors and malignant GBWT.
RESULTS: Seventy-five patients (mean age 56 ± 12.8 years, 46 females) were included. Forty-two patients had benign, and 33 had malignant GBWT. In the overall group, female gender (p = 0.018), lymphadenopathy (p = 0.011), and omental nodules (p = 0.044) were significantly associated with malignant GBWT. None of the DECT features differed significantly between benign and malignant GBWT in overall group. In the xanthogranulomatous cholecystitis (XGC, n = 9) vs. gallbladder cancer (GBC) (n = 33) subgroup, mean attenuation value at 140 keV LAP VMI was significantly associated with malignant GBWT [p = 0.023, area under curve 0.759 (95%CI 0.599-0.919)].
CONCLUSIONS: DECT-generated quantitative parameters do not add value in differentiating non-acute benign from malignant GBWT. However, DECT may have a role in differentiating XGC from GBC in a selected subgroup of patients. Further, larger studies may be necessary to confirm these findings.
CONCLUSIONS: In patients with non-acute gallbladder wall thickening in whom there is suspicion of xanthogranulomatous cholecystitis (XGC), DECT findings may allow differentiation of XGC from wall thickening type of gallbladder cancer.
CONCLUSIONS: Differentiation of benign and malignant gallbladder wall thickening (GBWT) at CT is challenging. Quantitative dual energy CT (DECT) features do not provide additional value in differentiating benign and malignant GBWT. DECT may be helpful in a subgroup of patients to differentiate xanthogranulomatous cholecystitis from gallbladder cancer.
METHODS: This prospective study comprised consecutive adults with GBWT who underwent late arterial phase (LAP) and portal venous phase (PVP) DECT between January 2022 and May 2023. The final diagnosis was based on histopathology or 3-6 months follow-up imaging. DECT images in LAP and PVP were assessed independently by two radiologists. The demographic, qualitative, and quantitative parameters were compared between two groups Multivariate logistic regression was performed to determine the association between the aforementioned factors and malignant GBWT.
RESULTS: Seventy-five patients (mean age 56 ± 12.8 years, 46 females) were included. Forty-two patients had benign, and 33 had malignant GBWT. In the overall group, female gender (p = 0.018), lymphadenopathy (p = 0.011), and omental nodules (p = 0.044) were significantly associated with malignant GBWT. None of the DECT features differed significantly between benign and malignant GBWT in overall group. In the xanthogranulomatous cholecystitis (XGC, n = 9) vs. gallbladder cancer (GBC) (n = 33) subgroup, mean attenuation value at 140 keV LAP VMI was significantly associated with malignant GBWT [p = 0.023, area under curve 0.759 (95%CI 0.599-0.919)].
CONCLUSIONS: DECT-generated quantitative parameters do not add value in differentiating non-acute benign from malignant GBWT. However, DECT may have a role in differentiating XGC from GBC in a selected subgroup of patients. Further, larger studies may be necessary to confirm these findings.
CONCLUSIONS: In patients with non-acute gallbladder wall thickening in whom there is suspicion of xanthogranulomatous cholecystitis (XGC), DECT findings may allow differentiation of XGC from wall thickening type of gallbladder cancer.
CONCLUSIONS: Differentiation of benign and malignant gallbladder wall thickening (GBWT) at CT is challenging. Quantitative dual energy CT (DECT) features do not provide additional value in differentiating benign and malignant GBWT. DECT may be helpful in a subgroup of patients to differentiate xanthogranulomatous cholecystitis from gallbladder cancer.
摘要：
目的：评估双能计算机断层扫描（DECT）在区分非急性良性和恶性胆囊壁增厚（GBWT）方面的性能。
方法：这项前瞻性研究包括2022年1月至2023年5月期间连续接受晚期动脉期（LAP）和门静脉期（PVP）DECT的GBWT成人。最终诊断基于组织病理学或3-6个月的随访影像学。LAP和PVP中的DECT图像由两名放射科医生独立评估。人口统计，定性，并比较两组之间的定量参数。进行多变量逻辑回归以确定上述因素与恶性GBWT之间的关联。
结果：75例患者（平均年龄56±12.8岁，包括46名女性）。42个病人是良性的,33例恶性GBWT。在整个群体中，女性（p=0.018），淋巴结病（p=0.011），和网膜结节(p=0.044)与恶性GBWT显著相关。在整个组中，良性和恶性GBWT之间的DECT特征均无明显差异。在黄色肉芽肿性胆囊炎（XGC，n=9)vs.胆囊癌（GBC）（n=33）亚组，140keVLAPVMI时的平均衰减值与恶性GBWT显著相关[p=0.023,曲线下面积0.759(95CI0.599-0.919)].
结论：DECT产生的定量参数在区分非急性良性和恶性GBWT方面没有增加价值。然而,在选定的患者亚组中，DECT可能在区分XGC和GBC中起作用。Further,可能需要更大规模的研究来证实这些发现.
结论：在非急性胆囊壁增厚患者中，怀疑有黄色肉芽肿性胆囊炎（XGC），DECT的发现可能允许将XGC与壁增厚型胆囊癌区分开。
结论：在CT上鉴别良性和恶性胆囊壁增厚（GBWT）具有挑战性。定量双能量CT（DECT）特征在区分良性和恶性GBWT方面没有额外的价值。DECT可能有助于将黄色肉芽肿性胆囊炎与胆囊癌区分开。
方法：这项前瞻性研究包括2022年1月至2023年5月期间连续接受晚期动脉期（LAP）和门静脉期（PVP）DECT的GBWT成人。最终诊断基于组织病理学或3-6个月的随访影像学。LAP和PVP中的DECT图像由两名放射科医生独立评估。人口统计，定性，并比较两组之间的定量参数。进行多变量逻辑回归以确定上述因素与恶性GBWT之间的关联。
结果：75例患者（平均年龄56±12.8岁，包括46名女性）。42个病人是良性的,33例恶性GBWT。在整个群体中，女性（p=0.018），淋巴结病（p=0.011），和网膜结节(p=0.044)与恶性GBWT显著相关。在整个组中，良性和恶性GBWT之间的DECT特征均无明显差异。在黄色肉芽肿性胆囊炎（XGC，n=9)vs.胆囊癌（GBC）（n=33）亚组，140keVLAPVMI时的平均衰减值与恶性GBWT显著相关[p=0.023,曲线下面积0.759(95CI0.599-0.919)].
结论：DECT产生的定量参数在区分非急性良性和恶性GBWT方面没有增加价值。然而,在选定的患者亚组中，DECT可能在区分XGC和GBC中起作用。Further,可能需要更大规模的研究来证实这些发现.
结论：在非急性胆囊壁增厚患者中，怀疑有黄色肉芽肿性胆囊炎（XGC），DECT的发现可能允许将XGC与壁增厚型胆囊癌区分开。
结论：在CT上鉴别良性和恶性胆囊壁增厚（GBWT）具有挑战性。定量双能量CT（DECT）特征在区分良性和恶性GBWT方面没有额外的价值。DECT可能有助于将黄色肉芽肿性胆囊炎与胆囊癌区分开。
