Differentiating Malignant From Benign Thickening of the Gallbladder Wall by the Use of Acoustic Radiation Force Impulse Elastography

Karasu

Euroasian Journal of Hepato-Gastroenterology

2019

Introduction: Gallbladder polyps (GBPs) are generally harmless, but the planning of diagnosis and treatment of the GBP is of clinical importance due to the high mortality risk of delays in the diagnosis of gallbladder carcinomas that show polypoid development. Materials and methods: GBPs are usually incidentally detected during ultrasonographic (USG) examinations of the abdomen. The risk of carcinoma development from polypoid lesions in the literature is reported as 0-27%. There is no consensus about the management of the GBPs. Herein, we reviewed the contemporary data to update our knowledge about diagnosis and treatment of gallbladder polyps. Results: Polyps can be identified in five different groups, primarily as neoplastic and non-neoplastic. Cholesterol polyps account for 60% of all cases. The most common (25%) benign polypoid lesions after cholesterol polyps are adenomyomas. Conclusion: Ultrasonography and endoscopic ultrasonography seems to be the most important tool in differential diagnosis and treatment. Ultrasonography should be repeated in every 3-12 months in cases that are thought to be risky. Nowadays, the most common treatment approach is to perform cholecystectomy in patients with polyps larger than 10 mm in diameter. Radical cholecystectomy and/or segmental liver resections should be planned in cases of malignancy.

Section: Figmentioning

confidence: 99%

Diagnosis and Treatment of Gallbladder Polyps: Current Perspectives

Karasu

Euroasian Journal of Hepato-Gastroenterology

2019

“…In a study by Kapoor et al [13], a mean shear wave velocity of 3.41 m/s (95% confidence interval, 3.1–3.7 m/s) was seen in patients with gallbladder carcinoma. At a cut-off value of 2.7 m/s, elastography showed overall accuracy of 92.8% with sensitivity and specificity of 100% and 91.3%, respectively, for diagnosing gallbladder carcinoma.…”

Section: Focal or Diffuse Asymmetric Wall Thickeningmentioning

confidence: 99%

Early Diagnosis of Gallbladder Carcinoma: An Algorithm Approach

Vijayakumar

Patil

et al. 2013

ISRN Radiology

Gall bladder carcinoma is the most common biliary tract cancer. Delayed presentation and early spread of tumor make it one of the lethal tumors with poor prognosis. Considering that simple cholecystectomy for T1 disease could offer a potential cure, it is increasingly needed to identify it at early stages. Identification of high-risk cases and offering prophylactic cholecystectomy can decrease the incidence of gallbladder carcinoma. With advances in diagnostic tools like contrast-enhanced endoscopic ultrasound, elastography, multidetctor CT, MRI, and PET scan, we can potentially diagnose gallbladder carcinoma at early stages. This paper reviews the various diagnostic modalities available and an algorithmic approach to early diagnosis of gallbladder carcinoma.

“…They reported a diagnostic performance that had a sensitivity and specificity of 100 and 91.3 %, respectively, and the cutoff value for diagnosing gallbladder carcinoma based on the mean shear wave velocity was 3.41 m/s ( P < 0.0001), and the area under the curve was 0.92. They concluded that elastography was a promising modality for differentiating between benign and malignant gallbladder wall thickening and should be used in combination with B-mode US [72]. In other biliary diseases, elastography has been reported to be useful as a noninvasive marker for primary biliary cirrhosis or the prediction of upper GI varices in children with biliary atresia [73–80].…”

Section: Elastography For the Biliary Systemmentioning

confidence: 99%

Elastography for hepato-biliary-pancreatic surgery

Inoue

Kokudo

2013

Surg Today

Palpation is a subjective and non-sharable diagnostic method. Recently, palpation has been supported and replaced by elastography, which provides a novel parameter of “stiffness” as a visual representation or quantified value. Today, elastography is performed using two major modalities: strain elastography and shear wave elastography. Strain elastography converts the extent of deformation during external compression into colors, displaying these colors as a strain map in a motion picture representing the relative elasticity inside the region of interest. Shear wave elastography can quantify the elasticity of a target by calculating the velocity of shear waves generated by a probe. In addition to superficial organs, elastography has also been applied to upper abdominal organs, including the liver, pancreas and spleen. The visualization of the stiffness of focal lesions in the liver or the pancreas has enabled a more sensitive and specific depiction of small, non-palpable nodules, which are difficult to depict using B-mode ultrasonography. The quantification of stiffness also enables non-invasive estimates of liver fibrosis, the risk of postoperative liver insufficiency and the risk of recurrence of viral hepatitis after transplantation. In this article, we review the major reports that have recently been published describing the effective application of elastography to solid upper abdominal organs in a clinical setting.