Benign gallbladder diseases: Imaging techniques and tips for differentiating with malignant gallbladder diseases.

Area of Science:

• Radiology
• Gastroenterology
• Oncology

Background:

• Benign gallbladder diseases often mimic malignant conditions through intraluminal lesions or wall thickening.
• Accurate differentiation is essential to avoid unnecessary interventions and ensure timely cancer treatment.

Purpose of the Study:

• To review imaging features distinguishing benign gallbladder diseases from gallbladder cancer.
• To highlight the role of various imaging modalities in evaluating gallbladder pathology.

Main Methods:

• Review of imaging findings in benign gallbladder diseases (gallstones, polyps, adenomyomatosis, cholecystitis) and gallbladder cancer.
• Emphasis on ultrasound (US), contrast-enhanced US (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI).

Main Results:

• Intraluminal lesions: Polyp size, stalk, and enhancement (CEUS), diffusion restriction (MRI/DWI) aid differentiation.
• Wall thickening: Rokitansky-Aschoff sinuses suggest adenomyomatosis; layered patterns and enhancement help exclude cancer.
• Inflammatory conditions: Acute cholecystitis may require CT; chronic cholecystitis with preserved two-layered wall and weak enhancement excludes malignancy.
• Xanthogranulomatous cholecystitis: MRI/DWI can differentiate from cancer based on fat content and diffusion.

Conclusions:

• Familiarity with characteristic imaging features is vital for accurate gallbladder disease diagnosis.
• Multimodality imaging approaches, including advanced techniques like DWI, improve diagnostic confidence in challenging cases.
• Distinguishing benign from malignant gallbladder conditions relies on integrating lesion morphology, wall characteristics, and functional imaging parameters.