Gallbladder cancer (GBC) is the most common malignancy of the biliary system, often associated with a poor prognosis in its advanced stages. The GB-RADS (Gallbladder Reporting and Data System) was recently developed to standardize the interpretation of ultrasound findings and evaluate the risk of malignancy. This study aims to assess the role of GB-RADS in predicting malignancy in cases of gallbladder wall thickening. All patients aged 18 years and above with gallbladder wall thickening > 3 mm in screening USG were included between August 2022 to March 2024. GB-RADS score was then compared to histopathological diagnosis of surgical specimen for resectable disease and FNAC/core needle biopsy for unresectable disease. A total of 150 patients were assessed in this study, all of whom underwent evaluation of GB-RADS via ultrasonography. Among them, 14 (9.2%) had a GB-RADS score of 2, 26 (17.5%) had a score of 3, 31 (20.8%) had a score of 4, and 79 (52.5%) had a score of 5. Following histopathological evaluation, 34 (22.5%) were found to be benign and 116 (77.5%) were malignant. The area under the ROC curve for GB-RADS scoring in predicting histopathology as malignant versus benign was 0.957 (95% CI: 0.926—0.987), indicating excellent diagnostic accuracy with a statistically significant result (p < 0.001). Ultrasonography (USG) has long been a key diagnostic tool for detecting gallbladder cancer (GBC), offering high sensitivity and specificity, particularly in the absence of mass-forming lesions. GB-RADS can serve as an excellent method for predicting carcinoma in patients with gallbladder wall thickening.
