The efficacy of real-time colour Doppler flow imaging on endoscopic ultrasonography for differential diagnosis between neoplastic and non-neoplastic gallbladder polyps

Kim, Su Young; Cho, Jae Hee; Kim, Eui Joo; Chung, Dong Hae; Kim, Kun Kuk; Park, Yeon Ho; Kim, Yeon Suk

doi:10.1007/s00330-017-5175-3

Cited by 26 publications

(21 citation statements)

References 32 publications

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“…Other methods including the use of real time colour Doppler flow EUS has been used to try and improve the diagnostic accuracy of EUS. Kim et al[ 34 ] found that the presence of a strong colour Doppler flow in a study 115 patients who underwent cholecystectomy for gallbladder polyps may help predict the presence of neoplastic polyps and therefore further research is warranted.…”

Section: The Role Of Different Imaging Modalities In Gallbladder Polymentioning

confidence: 99%

Current practices and future prospects for the management of gallbladder polyps: A topical review

McCain

Diamond

Jones

et al. 2018

WJG

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A gallbladder polyp is an elevation of the gallbladder mucosa that protrudes into the gallbladder lumen. Gallbladder polyps have an estimated prevalence in adults of between 0.3%-12.3%. However, only 5% of polyps are considered to be “true” gallbladder polyps, meaning that they are malignant or have malignant potential. The main radiological modality used for diagnosing and surveilling gallbladder polyps is transabdominal ultrasonography. However, evidence shows that other modalities such as endoscopic ultrasound may improve diagnostic accuracy. These are discussed in turn during the course of this review. Current guidelines recommend cholecystectomy for gallbladder polyps sized 10 mm and greater, although this threshold is lowered when other risk factors are identified. The evidence behind this practice is relatively low quality. This review identifies current gaps in the available evidence and highlights the necessity for further research to enable better decision making regarding which patients should undergo cholecystectomy, and/or radiological follow-up.

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Section: The Role Of Different Imaging Modalities In Gallbladder Polymentioning

confidence: 99%

Current practices and future prospects for the management of gallbladder polyps: A topical review

McCain

Diamond

Jones

et al. 2018

WJG

View full text Add to dashboard Cite

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“…The latter was not yet systematically scored in the current exploratory study, and therefore not incorporated in the results, but vascularity was seen in the high grade dysplasia case on both targeted TAUS (by colour doppler) and MRI, in line with literature suggesting vascular flow as major indication for neoplasia of GB polyps. 15,35 A large cohort of GB polyps evaluated by targeted TAUS could also further enable identification of new sonographic patterns of neoplastic and nonneoplastic polyp types, also including more sophisticated ultrasound techniques such as elastography and shear wave imaging, or superb microvascular imaging, which are currently used to differentiate benign and malignant lesions in the liver, breast and thyroid. [36][37][38][39][40] Regarding MRI, a more targeted MRI protocol should be considered to reduce artefacts and improve polyp visualization, to enable identification of more detailed MRI characteristics of GB polyps.…”

Section: Discussionmentioning

confidence: 99%

Imaging based flowchart for gallbladder polyp evaluation

Wennmacker

Lohman

Reuver

et al. 2021

Journal of Medical Imaging and Radiation Sciences

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“…The present study is not the only study to highlight the considerable overtreatment of gallbladder polyps, which underlines the need for improvements to ultrasound evaluation and patient selection for cholecystectomy for gallbladder polyps [20]. Multiple studies have outlined sonographic characteristics of gallbladder polyps that can be used to differentiate polyp type [6, 9-12, 21]. The most recent European guidelines have sought to incorporate this development partly by excluding definite nonneoplastic polyps prior to polyp size assessment based on “comet tail” artifacts, which can be seen in adenomyomatosis or cholesterol polyps [4].…”

Section: Discussionmentioning

confidence: 99%

Overtreatment of Nonneoplastic Gallbladder Polyps due to Inadequate Routine Ultrasound Assessment

et al. 2020

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Background: The primary aim was to assess the diagnostic accuracy of routine ultrasound assessment for gallbladder polyps. The secondary aim was to identify the characteristics that differentiate neoplastic polyps from nonneoplastic polyps. Methods: A total of 156 patients with histopathologically proven gallbladder polyps in 4 Dutch hospitals between 2003 and 2013 were included. Sensitivity and specificity of ultrasound for polyp size, number of polyps, and polyp type were assessed using histopathological findings as a reference standard. In addition, diagnostic accuracy of sonographic size ≥1 cm for neoplasia was assessed. Subgroup analysis for patients with polyps as primary indication for cholecystectomy was performed. The sonographic polyp characteristics on preoperative routine ultrasound were described. Results: Fifty-six percent of gallbladder polyps were preoperatively identified on ultrasound, of which 31% were neoplastic. Sensitivity and specificity of ultrasound to estimate polyp size were 93 and 43% (subgroup; 92 and 33%). Sensitivity and specificity of sonographic polyp size ≥1 cm for neoplasia were 86 and 32% (subgroup; 94 and 26%). No specific sonographic characteristics for neoplastic polyps could be established due to lack of reporting. Conclusion: Routine ultrasound assessment of polyps is associated with overestimation of polyp size and low specificity of sonographic size ≥1 cm for neoplasia, which contributes to surgical overtreatment of nonneoplastic polyps.

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The efficacy of real-time colour Doppler flow imaging on endoscopic ultrasonography for differential diagnosis between neoplastic and non-neoplastic gallbladder polyps

Abstract: • Differential diagnosis between neoplastic polyps and non-neoplastic polyps of GB is limited. • The use of real-time CDF-EUS was convenient, with high agreement between operators. • The real-time CDF-EUS is helpful in differential diagnosis of GB polyps.

Cited by 26 publications

References 32 publications

Current practices and future prospects for the management of gallbladder polyps: A topical review

Current practices and future prospects for the management of gallbladder polyps: A topical review

Imaging based flowchart for gallbladder polyp evaluation

Overtreatment of Nonneoplastic Gallbladder Polyps due to Inadequate Routine Ultrasound Assessment

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