Focusing in on gallbladder disease. Do current imaging modalities accurately depict the severity of final pathology? - 08/12/22
, Bryant Menke , W.T. Hillman Terzian , Ashley Raposo-Hadley , Kevin Cahoy , Bennett J. Berning , Samuel Cemaj , Andrew Kamien , Charity H. Evans , Emily Cantrell Abstract |
Background |
Accuracy of imaging modalities for gallbladder disease(GBD) remains questionable. We hypothesize ultrasonography(US), computed tomography(CT), and magnetic resonance imaging(MRI) poorly correlate with final pathologic analysis.
Methods |
This was a retrospective review of all patients who underwent cholecystectomy at our institution. Primary outcome was agreement between US, CT, and MRI, and final pathology report of the gallbladder. Cohen's Kappa statistic was used to describe the level of agreement (0 = agreement equivalent to chance, 0.1–0.2 = slight agreement, 0.21–0.40 = minimal/fair agreement, 0.41–0.60 = moderate agreement, 0.61–0.80 = substantial agreement, 0.81–0.99 = near perfect agreement, 1 = perfect agreement). Significance was set at p < 0.05.
Results |
1107 patients were enrolled. Average age was 48.6(±17.6); 64.2% were female. There was minimal agreement between the three imaging modalities and final pathology (US = 0.363; CT = 0.223; MRI = 0.351;p < 0.001).
Conclusion |
Poor agreement exists between imaging modalities and final pathology report for GBD. Urgent surgical intervention for patients presenting with symptoms of GBD should be considered, despite imaging results.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Cohen's Kappa statistic is used to describe agreement between modalities. |
• | Minimal agreement exists between US and final gallbladder disease (GBD) pathology. |
• | Only minimal agreement exists between CT and final GBD pathology. |
• | Urgent cholecystectomy should be considered for suspected GBD despite imaging. |
Keywords : Gallbladder disease, Ultrasonography, Cholecystectomy, Computed tomography, Cohen's kappa statistic
Plan
| ☆ | This research was presented via podium presentation during the 73rd annual Southwestern Surgical Congress in April 2022 in Wigwam, AZ. |
Vol 224 - N° 6
P. 1417-1420 - décembre 2022 Retour au numéro
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