Early detection of gallbladder cancer: Current status and future perspectives

Table 3 Sensitivity, specificity and limitation of traditional imaging modalities for early detection of gall bladder cancer

Imaging modalities	SN	SP	Accuracy	Advantages	Limitations	References
USG	65%-94%	70%-95%	80%-90%	Inexpensive, non-invasive, portable, and widely available	Low accuracy in differentiating benign vs malignant GB wall thickening	[45,69,70]
				Can flag suspicious case	Malignant small sessile polyps
					Operator dependent
					Nodal involvement
CEUS	90%-100%	90%-95%	55%-90%	Portable	Smaller lesion gives false positive results so less sensitive for smaller lesions	[55,57,71-74]
				Better modality for detecting vascularity and lesion characterization	Operator dependent
					Artefacts
					Not available widely
CECT	70%-100%	40%-100%	75%-95%	Better characterization staging	Limited sensitivity in small polyps, T1 lesions, thick walled	[60,61,75-77]
				Better anatomical detail	High cost
				Lymph node involvement	Radiation exposure
					Poor specificity to differentiate XGC, AC and GBC
					Not available in rural areas
MRI	70%-88%	60%-70%	92%	Excellent soft tissue contrast, good for delineating bile duct involvement	Miss early lesions with subtle findings	[78-80]
					Overdiagnosis of benign lesions
					High cost
					Not readily available in rural areas
PET	70%-80%	80%-85%	50%-70%	Only for distant metastasis	Cannot accurately differentiate benign inflammation and malignant thickening	[81,82]
					High cost and not readily available

SN: Sensitivity; SP: Specificity; MRI: Magnetic resonance imaging; CECT: Contrast-enhanced computed tomography; USG: Ultrasonography; CEUS: Contrast-enhanced ultrasound; PET: Positron emission tomography; SUV: Standardized uptake value; GB: Gall bladder; GBC: Gall bladder cancer; AC: Acute cholecystitis; XGC: Xantho granulomatous cholecystitis.