title: Magnetic resonance differentiation between T2 and T1 gallbladder carcinoma: significance of subserosal enhancement on the delayed phase dynamic study.
abstract: OBJECTIVE
  The aim of this study is to investigate whether subserosal enhancement on the delayed-phase dynamic magnetic resonance (MR) study (SED) can differentiate T2 from T1 gallbladder carcinoma (GBC).
  
  
  METHODS
  The institutional research board approved this retrospective study. Between 1997 and 2006, there were surgically proven 11 T1 and 21 T2 GBC in 30 patients, all of whom had undergone preoperative contrast enhanced dynamic MR study, either with a 2D sequence (n=17) or 3D sequences (n=15). All images were reviewed by two radiologists for the presence of SED, and receiver operating characteristic (ROC) curve analysis was performed. Sensitivity, specificity, positive and negative predictive values were calculated by consensus.
  
  
  RESULTS
  The areas under the ROC curves of the two readers were 0.91 and 0.86, and the kappa value was 0.78. Of the 21 T2 GBC, 18 and 3 showed positive and negative SED, respectively. Of the 11 T1 GBC, 1 and 10 showed positive and negative SED, respectively. The sensitivity, specificity, positive and negative predictive values of SED for diagnosing T2 lesions were 86%, 88%, 91% and 77%, respectively.
  
  
  CONCLUSIONS
  In conclusion, SED may be a useful sign to differentiate T2 from T1 GBC, which would affect the preoperative surgical planning of the patients.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan. kengo@fukuoka-u.ac.jp
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: Yunosuke
authors.initials: Y
authors.lastname: Nishihara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ushijima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity