Diagnostic performance and inter-observer variability to differentiate between T1- and T2-stage gallbladder cancers...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Gallbladder cancer (GB cancer) staging is crucial for treatment planning.
• Accurate differentiation between T1 and T2 stages impacts patient management.
• Multi-detector row CT (MDCT) is a common imaging modality for GB cancer evaluation.

Purpose of the Study:

• To assess the diagnostic performance of MDCT in distinguishing between T1 and T2 GB cancers.
• To evaluate the inter-observer variability among radiologists in T-staging GB cancer using MDCT.

Main Methods:

• Retrospective analysis of 151 patients with surgically confirmed T1 or T2 GB cancer.
• Contrast-enhanced MDCT scans from 2016-2020 were reviewed by five radiologists.
• Morphological classification (polypoid, polypoid with wall thickening, wall thickening) and ROC analysis were performed.

Main Results:

• The area under the ROC curve for T-staging ranged from 0.69 to 0.80 (median 0.77).
• Overall accuracy was 78%, with higher sensitivity but lower specificity in experienced radiologists.
• Fair inter-observer agreement (κ=0.36) was observed, with accuracy increasing with tumor type complexity.

Conclusions:

• MDCT has limited accuracy for differentiating T1 and T2 GB cancer.
• Considerable inter-observer variability exists, potentially affecting diagnostic reliability.
• Further improvements in imaging criteria or techniques may be needed for precise T-staging.