Nam Kyung Lee MD, Presenter: Nothing to Disclose

Suk Kim MD, Abstract Co-Author: Nothing to Disclose

Ji Eun Jo, Abstract Co-Author: Nothing to Disclose

Jihyun Bae MD, Abstract Co-Author: Nothing to Disclose

Tae Un Kim MD, Abstract Co-Author: Nothing to Disclose

Dong Uk Kim, Abstract Co-Author: Nothing to Disclose

Hyung Il Seo MD, Abstract Co-Author: Nothing to Disclose

 Generally, histologic grades of gallbladder adenocarcinoma correlate with survival. However, it is difficult to differentiate histologic grades of gallbladder adenocarcinoma by imaging. The purpose of our study was to investigate the value of DWI for differentiating gallbladder adenocarcinoma from adenoma, and differentiating gallbladder adenocarcinoma according to histologic grades.

 Fourty-three patients with gallbladder adenocarcinoma and 8 patients with adenoma who had undergone MR with respiratory-triggered DWI were included in this retrospective study. Signal intensity of gallbladder adenocarcinoma and adenoma was analyzed on DWI (b=800s/mm2), in comparison with spleen signal by Chi-square test. ADC values of adenocarcinoma and adenoma were compared separately for 1.5-T and 3.0-T by Mann-Whitney U test. Gallbladder adenocarcinomas were divided to three groups according to histologic grades; well-differentiated (n=10), moderately-differentiated (n=17), and moderate-to-poor- and poor-differentiated adenocarcinomas (n=16). Qualitative DWI analysis was performed according to histologic grades by Chi-square test. ADC values according to histologic grades were also compared separately for 1.5-T and 3.0-T by Kruskal-Wallis test.

 DWI intensity was significantly different between gallbladder adenocarcinoma and adenoma. ADC values of gallbladder adenocarcinoma and adenoma were 0.999±0212×10−3 and 1.815±0.332×10−3mm2/sec, respectively at 1.5-T (p=0.002), and 1.179±0.420×10−3 and 2.105±0.489×10−3mm2/sec, respectively at 3.0-T (p=0.006). DWI intensity was not significantly different according to histologic grades of gallbladder adenocarcinoma. However, ADC values of well-differentiated adenocarcinoma were significantly higher than other high-grade adenocarcinomas. ADC values of well-differentiated, moderate-differentiated, and moderate-to-poor and poor-differentiated adenocarcinomas were 1.240±0.152×10−3, 0.990±0.252×10−3, and 0.903±0.064 ×10−3mm2/sec, respectively at 1.5-T (p=0.033), and 1.512±0.382×10−3, 1.088±0.452×10−3, and 0.984±0.260×10−3mm2/sec, respectively at 3.0-T (p=0.030).

 DWI can be reliable for differentiating gallbladder adenocarcinoma according to histologic grades as well as differentiating gallbladder adenocarcinoma from adenoma.

 DWI can be useful to predict the survival rate of gallbladder carcinoma by differentiating gallbladder adenocarcinoma according to histologic grades.

Lee, N, Kim, S, Jo, J, Bae, J, Kim, T, Kim, D, Seo, H, Diffusion-weighted MR Imaging of Gallbladder Adenocarcinoma: Differentiation from Adenoma and Analysis with Emphasis on Histologic Grades.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044275.html