Gallbladder carcinoma and its differential diagnosis at MRI: What radiologists should know

Camila Lopes Vendrami, Michael J. Magnetta, Pardeep K. Mittal, Courtney C. Moreno, Frank H. Miller*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Gallbladder carcinoma is the most common cancer of the biliary system. It is challenging to diagnose because patients are often asymptomatic or present with nonspecific symptoms that mimic common benign diseases. Surgical excision is the only curative therapy and is best accomplished at early non–locally advanced stages. Unfortunately, gallbladder cancer often manifests at late locally advanced stages, precluding cure. Early tumors are often incidentally detected at imaging or at cholecystectomy performed for another indication. Typical imaging features of localized disease include asymmetric gallbladder wall thickening, polyps larger than 1.0 cm, and a solid mass replacing the gallbladder lumen. Advanced tumors are often infiltrative and can be confusing at CT and MRI owing to their large size. Determination of the origin of the lesion is paramount to narrow the differential diagnosis but is often challenging. It is important to identify gallbladder cancer and distinguish it from other benign and malignant hepatobiliary processes. Since surgical resection is the only curative treatment option, radiologist understanding and interpretation of pathways of nodal and infiltrative tumor spread can direct surgery or preclude patients who may not benefit from surgery.While both CT and MRI are effective, MRI provides superior soft-tissue characterization of the gallbladder and biliary tree and is a useful imaging tool for diagnosis, staging, and evaluation of treatment response.

Original languageEnglish (US)
Pages (from-to)78-95
Number of pages18
JournalRadiographics
Volume41
Issue number1
DOIs
StatePublished - Jan 1 2021

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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