 Hello everyone, the topic for my presentation is CT findings in gallbladder carcinoma, a study from a tertiary care center in North India. Introduction. Gallbladder carcinoma is a highly malignant disease. It is the most common malaria tract malignancy. Patients usually present late when the disease is at advanced stage, so it is a very aggressive disease with poor prognosis. Gallbladder carcinoma is more common in females than in males. India contributes to 10% of global burden of this disease with highest incidence in northern, eastern, central and northeastern parts of the country. So early diagnosis of gallbladder carcinoma is the need of the R. Role of ultrasound is limited in the diagnosis of this disease, so CT is a useful modality for diagnosis as well as staging of the gallbladder carcinoma as it provides detailed information regarding the local invasion of the disease as well as the global spread and distant metastasis. So aim of the present study is to evaluate the role of CT as a non-invasive tool for diagnosis and staging of gallbladder carcinoma and to describe the spectrum of CT features of this disease. Methodology. The study was conducted on 40 patients in the department of radio diagnosis and imaging, GMC jumping. Informed carcinoma was taken from all patients. Detailed history examination was done. Inclusion criteria, patients with clinical suspicion or sonographic diagnosis of gallbladder mass were included. And exclusion criteria, patients who had undergone previous chemotherapy surgery or any intervention related to gallbladder were excluded. MDCT protocol, the patients fasted 6 to 8 hours prior to the study. All contrast was given for bauleplacification. Non-ionic, iodinated contrast, IOhexol was used as intravenous contrast agent. Non-contrast CT followed by bi- or tri-phasic CT was done. Same actual slices and multi-planar reconstruction sections were updated. Coming to images, this is the first case showing a heterogeneously enhancing mass lesion replacing the gallbladder. This is the most common pattern found in the present study. Next pattern was asymmetric mural thickening of the gallbladder wall. In this case, actual CT scan section showing asymmetric mural thickening of the body of the gallbladder and in the second case there is mural thickening involving the fundus. And third and least common pattern was polypodal mass arising from the gallbladder wall and protruding into the lumen as shown by the arrow. Infiltration of hepatic parenchyma was the most common associated feature found in the study. This is an actual CT scan section showing a mass in the gallbladder region with contiguous infiltration into the adjacent hepatic parenchyma. Similarly, in this case, this is a coronary formatted image showing mass in the gallbladder with associated polylithiasis and the lesion is seen infiltrating into the adjacent lumen parenchyma. Then patterns of extramural extension. This is a case with gallbladder carcinoma which is showing loss of fat pain with the adjacent entroduteral region. Similarly, in this case, the gallbladder mass is seen infiltrating into the adjacent head of the pantheas as well as into the diodenum. In the third case, similarly, there is the infiltration of the gallbladder mass into the diodenum. And this is another case, coronary formatted image showing asymmetric mural thickening of gallbladder with loss of fat pains with the adjacent hepatic plexus. Then biliria tract involvement was also noted in some patients with gallbladder carcinoma. If this is an actual CT scan showing asymmetric mural thickening of gallbladder, contiguous involvement of common bilita. Intrahepatic biliria dilatation was noted in this case and coronary formatted image is showing involvement of biliria confluence as well as the cystic duct. Then vascular involvement was also noted in this case is mass is seen in the gallbladder fossa with evidence of thrombosis within the right branch of the portal vein. Another case showing gallbladder mass with a periportal necrotic nodal mass causing encasement of the portal vein as well as thrombosis within the portal vein. Similarly, another case nodal mass in the periportal region is seen causing encasement and infiltration into the portal vein as well as causing encasement of the hepatic artery. Then different patterns of lymph node involvement. This is a case showing of gallbladder carcinoma showing a conglomerate necrotic periportal nodal mass causing encasement of the portal vein. In addition, peripancreatic erydeodinol nodes were also noted. Similarly, in this case, lymph nodes are seen along the celiac axis. In this case, nodes are noted along the supramizentric axis. Similarly, in this case, necrotic deiotic, pariotic, retroperitoneal lymph nodes are noted. Then patterns of metastasis found in the present study in patients with gallbladder carcinoma. This was a case with gallbladder carcinoma in which axial sections from the chest showing rounded opacities in bilateral lung fields with neural effusion. Another case with gallbladder carcinoma, there was a heterogeneous mass lesion in the right adrenu gland, suggesting metastasis. Similarly, these two cases are showing presence of hepatic metastasis. In addition, fomental metastasis was also noted in some patients with gallbladder carcinoma in the form of well-defined rounded fomental nodules. In the results of the present study, among the 40 patients included in the study, 65% were females and 35% were males. The most common age group involved was 61 to 70%. 61 to 70 years. Then polylatesis was seen in 62.5% of cases. Then three patterns of the lesion were seen in the present study. The most common was a mass replacing the gallbladder, seeing in 62.5% and another was wall thickening of the gallbladder and the least common was polypartil mass. Associated features noted were hepatic infiltration, involvement of the introdiodinum, pancreatic, colonic, bilary and vascular involvement. Then TNM staging was done according to the 8th AJCC guidelines in which T1 is tumor confined to the lamina property or muscle layer. T2 is tumor extending up to the serosar, T3 is invading the adjacent organs, T4 is vascular or distant organ involvement. N1 is 1, 2, 3 nodal involvement and N4 is more than or more nodal involvement and M1 is distant metastatic involvement. In this study, T1, T2 stage was seen in 10% T3 in 24% and T4 in 66% cases. Similarly, N1 and N2 stages were seen in 25 and 55% respectively, M1 was seen in 25% cases. Histrocathological examination was done in 38 cases, of which 35 cases were proven to have gallbladder carcinoma and the most common pattern was adenocarcinoma. Two cases were xanthogranulomatosporosis status. Discussion, CT scan provides a detailed evaluation of the extent and the staging of gallbladder carcinoma, which is key factor for planning the operative procedure. In the present study, three patterns of involvement were seen. The most common was mast replacing the gallbladder, other was wall thickening pattern and the least common was polyparter lesion. Associated polylethiasis was seen in a large number of cases, which is similar to studies from North India. The most common associated feature was hepatic varenchyme infiltration, which is explained by the fact that there is a lack of the muscularis mucosia and submucosa in the gallbladder wall. Urinal pancreatic hepatic involvement was also clearly depicted by the CT in addition lymphatic and distinct organ lymphatic metastases and distinct organ metastases were also clearly depicted by the CT scan. So from the study, we can conclude that the CT is the diagnostic modality of choice for diagnosis and staging of gallbladder carcinoma, which is essential for the preoperative planning and patient management. These were the references used in the present study. Thanks.