Journal of the Dow University of Health Sciences (Apr 2016)
The Diagnostic Accuracy of CT Scan in Evaluation of Gallbladder Carcinoma
Abstract
Objective: To determine the diagnostic accuracy of CT scan in evaluation of Gallbladder Carcinoma (GBC) taking histopathology as gold standard. Study Design: Cross-sectional, Descriptive study. The study was conducted at Department of Radiology, Dow Medical College and Civil Hospital, Karachi from 1st January 2014 to 31st December 2014. Materials and Methods: This study comprises 434 patients of either gender, age between 30 to 70 years, with history of jaundice, pain in right hypochondrium/epigastrium and weight loss with suspicion of carcinoma gall bladder, referred to the Radiology Department of Civil Hospital Karachi over a period of 12 months. Post operated cases without CT scan and patients allergic to the contrast material were excluded from the study. Patients who fulfilled the above-mentioned criteria, followed to CT scan with intravenous contrast and findings were documented. Patients were referred for surgery. During surgery sample for histopathology was taken which was used as gold standard. Data were entered and analyzed using computer program SPSS- 21. Descriptive statistics were applied to calculate mean and standard deviation for the quantitative variables. The sensitivity, specificity; positive predictive value, negative predictive value, and diagnostic accuracy of CT scan were calculated. Results: Out of 434 patients, there were 183(42%) male and 251(58%) female patients in this study. The overall mean age was 53.37±7.18 years with range 28 (38-66) years. With histopathological findings gallbladder carcinoma (GBC) was found positive in 292 patients and with CT scan findings gallbladder carcinoma (GBC) was found positive in 285 patients. The mean age of patients with positive histopathological findings for gallbladder carcinoma (GBC) was 54.36±6.95 years and the mean age of patients with positive CT scan findings for gallbladder carcinoma was 53.51±7.28 years. 274 patients were true positive and 132 patients were true negative. Sensitivity, specificity, PPV, NPV and accuracy were 94.2%, 92.3%, 96.1%, 88.6%, and 93.5% respectively. Conclusion: The use of computed tomography can help early diagnosis of GBC. Contrast-enhanced MDCT was effective in identifying the criteria for resectability of the tumor and in disease staging. The histopathological diagnosis of the present study correlated well with CT scan in diagnosis of gallbladder malignancy.
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