Diagnosis of the depth of invasion of gallbladder carcinoma by EUS.
BACKGROUND
The prognosis of gallbladder carcinoma is dismal and relates to the depth of invasion as expressed by the T factor in TNM staging. We evaluated the utility of endoscopic ultrasound (EUS) in the diagnosis of the depth of invasion of gallbladder cancer.


METHODS
Thirty-nine patients who underwent both EUS and surgery were included in this study. The EUS images were classified according to the relation between tumor echo pattern and gallbladder-wall structure, and the resulting types were compared with depth of invasion as determined histologically. Based on the results, a set of diagnostic criteria is proposed.


RESULTS
The EUS images were classified into four categories. Type A is a pedunculated mass with a fine-nodular surface and intact neighboring wall. Type B is a broad-based mass with an irregular surface and intact outer hyperechoic layer of the adjacent wall. In type C, the outer hyperechoic layer is irregular due to a mass echo, whereas, in type D, the outer hyperechoic layer is disrupted by a mass echo. Each of the four categories of EUS images correlated well with the histologic depth of invasion.


CONCLUSIONS
EUS is useful in the T staging of gallbladder cancer.
Fujita
N
N
Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan.
Noda
Y
Y
Kobayashi
G
G
Kimura
K
K
Yago
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D019160:Endosonography / Q000295:instrumentation; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging