Focusing in on gallbladder disease. Do current imaging modalities accurately depict the severity of final pathology?

Zachary M. Bauman, Bryant Menke, W. T.Hillman Terzian, Ashley Raposo-Hadley, Kevin Cahoy, Bennett J. Berning, Samuel Cemaj, Andrew Kamien, Charity H. Evans, Emily Cantrell

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)1417-1420
Number of pages4
JournalAmerican journal of surgery
Issue number6
StatePublished - Dec 2022


  • Cholecystectomy
  • Cohen's kappa statistic
  • Computed tomography
  • Gallbladder disease
  • Ultrasonography

ASJC Scopus subject areas

  • Surgery


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