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High b-value diffusion-weighted magnetic resonance imaging for gallbladder lesions: differentiation between benignity
Takahisa Ogawa1, Jun Horaguchi, Naotaka Fujita
1Department of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, Japan. t-ogawa@openhp.or.jp
Journal of Gastroenterology
|May 12, 2012
Summary
High b-value diffusion-weighted imaging (DWI) shows higher signal rates and lower ADC values in gallbladder cancer compared to benign diseases. DWI aids gallbladder lesion diagnosis but may yield false positives in acute cholecystitis.
Area of Science:
- Radiology
- Oncology
- Gastroenterology
Background:
- Diffusion-weighted magnetic resonance imaging (DWI) is increasingly used for abdominal organs.
- Limited studies exist on DWI applications for gallbladder diseases.
- This study assesses high b-value DWI for gallbladder pathologies.
Purpose of the Study:
- To evaluate the diagnostic utility of high b-value DWI for gallbladder diseases.
- To determine the effectiveness of DWI in differentiating malignant from benign gallbladder lesions.
- To identify limitations of DWI in gallbladder imaging.
Main Methods:
- 153 patients with gallbladder wall thickening or polypoid lesions underwent DWI.
- Patients included 36 with gallbladder cancer and 117 with benign diseases (chronic cholecystitis, adenomyomatosis, etc.).
- Evaluated DWI positive signal rate and apparent diffusion coefficient (ADC) values.
Main Results:
- Gallbladder cancer showed a significantly higher positive signal rate (78%) than benign diseases (22%) on DWI (p < 0.001).
- Mean ADC values were lower for gallbladder cancer (1.83 × 10⁻³ mm²/s) versus benign diseases (2.60 × 10⁻³ mm²/s) (p < 0.001).
- Acute cholecystitis cases presented higher DWI signal and lower ADC values, mimicking malignancy.
Conclusions:
- High b-value DWI enhances diagnostic capability for gallbladder wall thickening and polypoid lesions.
- DWI offers advantages over other modalities for gallbladder disease assessment.
- Acute cholecystitis can cause false-positive DWI findings, a key limitation.
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