title: Biological behavior and disease pattern of carcinoma gallbladder shown on 64-slice CT scanner: a hospital-based retrospective observational study and our experience.
abstract: OBJECTIVE
  The aim of this diagnostic observational study was to assess the spread and biological behavior of gallbladder cancer using 64-slice computerized tomography (CT) scanner in this particular geographic belt (eastern Uttar Pradesh, western Bihar, and northern Madhya Pradesh provinces of North India). Indians are ethnically and culturally different from their Western counterparts among whom the incidence of this disease is comparatively low.
  
  
  METHODS
  After systemic examination, all patients (87) were subjected to ultrasonographic examination. All cases were histopathologically proven. Confirmed cases were subjected to volumetric CT examination of abdomen and pelvis, plain, post contrast and delayed phase.
  
  
  RESULTS
  Majority of the cases were adenocarcinoma. There was female preponderance with majority belonging to fifth and sixth decades. Commonest presentation was diffuse, irregular, enhancing wall thickening in 49.4%. Majority had invasion of liver parenchyma (74.7%). Cholelithiasis was seen in 48.3% cases. Invasion of biliary radicals was high (13.8-18.4%). Eleven cases had invasion of portal vein and tumor thrombus, with hepatic artery invasion in one case. In two cases, both hepatic artery and portal vein invasion was seen. Portal and peripancreatic nodal metastasis was seen in 58.5%. Distant metastasis was reported.
  
  
  CONCLUSIONS
  Few studies involving the Indian population have attempted to use multi-row detector CT to define the biological behavior of carcinoma gallbladder. The opinion whether the pathology is operable or non-operable can reasonably be given. This large-scale, single-center study gives insight about the epidemiology and biological behavior of carcinoma gallbladder.
authors.affiliation: Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi, India.
authors.forename: A N D
authors.initials: AN
authors.lastname: Dwivedi
authors.forename: M
authors.initials: M
authors.lastname: Pandey
authors.forename: R C
authors.initials: RC
authors.lastname: Shukla
authors.forename: V K
authors.initials: VK
authors.lastname: Shukla
authors.forename: S
authors.initials: S
authors.lastname: Gaharwar
authors.forename: B N
authors.initials: BN
authors.lastname: Maurya
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary; D000368:Aged; D005260:Female; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D015994:Incidence; D007194:India; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*