Diagnostic accuracy of MDCT in differentiating gallbladder cancer from acute and xanthogranulomatous cholecystitis.

•Differentiating gallbladder cancer from benign pathology is important because an accurate preoperative diagnosis informs surgical planning.•Our study shows MDCT has moderate sensitivity, poor specificity, and moderate-to-substantial inter-rater repeatability for the differentiation of gallbladder cancer from acute and xanthogranulomatous cholecystitis.•In many cases, accurate differentiation of gallbladder cancer from xanthogranulomatous cholecystitis is not possible by MDCT alone.