The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations

Abstract

Aims: Gallbladder polyps often have a benign nature. Current guidelines suggest surgical removal of polyps greater than 10 mm. However, the accuracy of the size criteria is limited because neoplasia can be found in gallbladder polyps less than 10 mm. The aim of this study was to evaluate the feasibility of real time elastography for gallbladder polyps and to demonstrate the elasticity properties of the polyps. Material and method: Fifty-three polypoid lesions of the gallbladder were prospectively examined with real-time elastography. Of these patients, 52 had a diagnosis of benign gallbladder polyps and one patient was accepted as a gallbladder carcinoma due to its clinical and radiological findings. B-mode and real-time elastographic images were simultaneously presented as a two-panel image, and the elastogram was displayed in a color scale that ranged from red (greatest strain, softest component), to green (average strain, intermediate component), to blue (no strain, hardest component). Results: The mean size for benign gallbladder polyps was 7.2 ± 3 mm (range, 5-21 mm). All benign gallbladder polyps on consecutive real-time elastographic images appeared as having a high-strain elastographic pattern. Only one patient who was accepted with gallbladder carcinoma had a gallbladder polyp with low elasticity properties. Conclusions: Our study showed that real time elastography of gallbladder polyps is feasible. This novel approach may be useful for the characterization of polypoid lesions of the gallbladder.

CEUS in the differential diagnosis between biliary sludge, benign lesions and malignant lesions

“…In addition, new elastographic technology, which is increasingly emerging [35,36], may contribute in the future to settle these doubts, as has been reported by some preliminary observations [37].…”

Gallbladder polypoid lesions: Current practices and future prospects

“…Real-time elastography is a dynamic technique that objectively assesses the elastic properties of tissues by measuring the degree of deformation under the action of external forces. Teber et al [ 75 ] initially assessed that real-time elastography is feasible in the diagnosis of GPLs and benign lesions with high-strain elastography patterns. However, there are few studies and clinical applications of elastography, and more clinical studies are needed to understand the effectiveness of this technology in diagnosing GPLs.…”

The Role of Transabdominal Ultrasound Elastography in Gastrointestinal Non-Liver Diseases: Current Application and Future Prospectives

“…US-E could be an additional tool to distinguish malignancies from benign condition of gallbladder wall. Using SE, gallbladder polyps were characterized by medium-high strain (soft or moderately soft) compared to only one single small nodule (measuring 19 mm) defined as gallbladder carcinoma which exhibited low strain (high stiffness) [ 83 ]. Considering differential diagnosis between benign wall thickening and gallbladder carcinoma, Kapoor et al, reported that the p-SWE values could distinguish between the two conditions with 92.8% accuracy [ 84 ].…”