Two-dimensional Shear Wave Elastography: Utility in Differentiating Gallbladder Cancer From Chronic Cholecystitis

Area of Science:

• Medical Imaging
• Hepatobiliary Surgery
• Oncology

Background:

• Gallbladder wall thickening can indicate malignancy, necessitating accurate diagnostic tools.
• Distinguishing between benign and malignant causes of gallbladder wall thickening is crucial for patient management.

Purpose of the Study:

• To evaluate the effectiveness of 2D shear wave elastography (SWE) in assessing gallbladder wall thickening.
• To establish cut-off values for shear wave elasticity (SWe) to differentiate benign from malignant gallbladder wall thickening.

Main Methods:

• A prospective study involving patients with gallstone disease (GSD), gallbladder cancer (GBC), and healthy controls.
• 2D ultrasound (USG) and 2D SWE were performed on the gallbladder in different regions.
• Comparison of SWe values between GBC, GSD, and control groups.

Main Results:

• Mean SWe in the abnormal area of GBC (34.99 ± 17.77 kPa) was significantly higher than in the uninvolved region of GBC (18.27 ± 8.12 kPa) and in GSD (12.27 ± 4.13 kPa) and controls (10.52 ± 3.75 kPa).
• Receiver Operating Characteristic (ROC) analysis demonstrated an Area Under the Curve (AUC) of 0.927.
• A cut-off value of 20 kPa yielded 91.3% sensitivity and 83.5% specificity for diagnosing GBC.

Conclusions:

• 2D SWE is a valuable adjunct to grey-scale USG for differentiating malignant from benign gallbladder wall thickening.
• SWE may aid in the early detection of gallbladder malignancy in patients with GSD.