Highlights
- •Cohen's Kappa statistic is used to describe agreement between modalities.
- •Minimal agreement exists between US and final gallbladder disease (GBD) pathology.
- •Only minimal agreement exists between CT and final GBD pathology.
- •Urgent cholecystectomy should be considered for suspected GBD despite imaging.
Abstract
Background
Accuracy of imaging modalities for gallbladder disease(GBD) remains questionable.
We hypothesize ultrasonography(US), computed tomography(CT), and magnetic resonance
imaging(MRI) poorly correlate with final pathologic analysis.
Methods
This was a retrospective review of all patients who underwent cholecystectomy at our
institution. Primary outcome was agreement between US, CT, and MRI, and final pathology
report of the gallbladder. Cohen's Kappa statistic was used to describe the level
of agreement (0 = agreement equivalent to chance, 0.1–0.2 = slight agreement, 0.21–0.40 = minimal/fair
agreement, 0.41–0.60 = moderate agreement, 0.61–0.80 = substantial agreement, 0.81–0.99 = near
perfect agreement, 1 = perfect agreement). Significance was set at p < 0.05.
Results
1107 patients were enrolled. Average age was 48.6(±17.6); 64.2% were female. There
was minimal agreement between the three imaging modalities and final pathology (US = 0.363;
CT = 0.223; MRI = 0.351;p < 0.001).
Conclusion
Poor agreement exists between imaging modalities and final pathology report for GBD.
Urgent surgical intervention for patients presenting with symptoms of GBD should be
considered, despite imaging results.
Keywords
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Article info
Publication history
Published online: October 16, 2022
Accepted:
October 13,
2022
Received in revised form:
September 27,
2022
Received:
March 25,
2022
Footnotes
☆This research was presented via podium presentation during the 73rd annual Southwestern Surgical Congress in April 2022 in Wigwam, AZ.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
