ReviewInsights into imaging2025
What imaging modalities should be considered in suspected acute acalculous cholecystitis? A review of the evidence.
Review in Insights into imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
0 citing papers in PubMed.
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundRadiological assessment remains crucial for acute acalculous cholecystitis (AAC) diagnosis, however, there is debate regarding the optimal imaging pathway. In the clinical setting, the decision to intervene, and the chosen procedure, are greatly influenced by imaging findings, and there is a need for a clear evaluation of each imaging modality's proficiency for AAC detection and its prognostic utility.
methodsWe performed a survey of the literature on the radiological diagnosis of AAC. Prospective and retrospective studies were selected if they examined the diagnostic utility of the imaging modality using histology as the ground truth, and had a sample size of greater than ten patients.
resultsSeventeen relevant studies were identified, which analysed US, hepatobiliary iminodiacetic acid (HIDA) scan, CT or MRI. The US has a reported specificity of between 93% and 97%, however, the sensitivity varied widely from 20% to 100%. The specificity of HIDA was reported as between 78% and 100%, but again, the sensitivity varied, between 38% and 100%. The literature on CT and MRI is limited, and there is no clear benefit over US for AAC diagnosis, however, they may be valuable for ruling out other diagnoses, or for surgical planning.
conclusionWhile radiological assessment holds utility in the management of suspected AAC, further research is required to properly define its role. Future research should focus on well-designed prospective studies to establish the diagnostic performance of both individual and multimodal imaging strategies in AAC, as well as the standardisation of imaging criteria and protocols across institutions. CRITICAL RELEVANCE STATEMENT: Prompt radiological diagnosis of AAC can prevent complications and improve patient survival, however, radiological assessment still varies between institutions. Consequently, there is an urgent need for the diagnostic performance of imaging strategies to be established, and protocols across institutions to be standardised. KEY POINTS: Radiological assessment is crucial for early diagnosis and prompt management of AAC. CT, MRI and HIDA scans demonstrate minimal benefit over US for diagnosis. Further research is required for evidence-based standardisation of imaging criteria and protocols.
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