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Risk stratification of gallbladder polyps larger than 10 mm using high-resolution ultrasonography and texture analysis

  • Gastrointestinal
  • Published:
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Abstract

Objectives

To assess important features for risk stratification of gallbladder (GB) polyps >10 mm using high-resolution ultrasonography (HRUS) and texture analysis.

Methods

We included 136 patients with GB polyps (>10 mm) who underwent both HRUS and cholecystectomy (non-neoplastic, n = 58; adenomatous, n = 32; and carcinoma, n = 46). Two radiologists retrospectively assessed HRUS findings and texture analysis. Multivariate analysis was performed to identify significant predictors for neoplastic polyps and carcinomas.

Results

Single polyp (OR, 3.680–3.856) and larger size (OR, 1.450–1.477) were independently associated with neoplastic polyps (p < 0.05). In a single or polyp >14 mm, sensitivity for differentiating neoplastic from non-neoplastic polyps was 92.3%. To differentiate carcinoma from adenoma, sessile shape (OR, 9.485–41.257), larger size (OR, 1.267–1.303), higher skewness (OR, 6.382) and lower grey-level co-occurrence matrices (GLCM) contrast (OR, 0.963) were significant predictors (p < 0.05). In a polyp >22 mm or sessile, sensitivity for differentiating carcinomas from adenomas was 93.5–95.7%. If a polyp demonstrated at least one HRUS finding and at least one texture feature, the specificity for diagnosing carcinoma was increased to 90.6–93.8%.

Conclusion

In a GB polyp >10 mm, single and diameter >14 mm were useful for predicting neoplastic polyps. In neoplastic polyps, sessile shape, diameter >22 mm, higher skewness and lower GLCM contrast were useful for predicting carcinoma.

Key Points

• Risk of neoplastic polyp is low in <14 mm and multiple polyps

• A sessile polyp or >22 mm has increased risk for GB carcinomas

• Higher skewness and lower GLCM contrast are predictors of GB carcinoma

• HRUS is useful for risk stratification of GB polyps >1 cm

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Acknowledgements

We also thank Bonnie Hami, M.A. (USA) for her editorial assistance in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea

    Tae Won Choi, Jung Hoon Kim, Sang Joon Park, Su Joa Ahn, Ijin Joo & Joon Koo Han

  2. Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea

    Jung Hoon Kim & Joon Koo Han

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  1. Tae Won Choi
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Correspondence to Jung Hoon Kim.

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Guarantor

The scientific guarantor of this publication is Joon Koo Han, M.D.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

Tae Won Choi MD has significant statistical expertise and no complex statistical methods were necessary for this paper.

Ethical approval

Institutional review board approval was obtained (IRB No. 1608-144-787).

Informed consent

This retrospective study was approved by our institutional review board, and patient informed consent was waived.

Methodology

• Retrospective

• Diagnostic study

• Performed at one institution

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Choi, T.W., Kim, J.H., Park, S.J. et al. Risk stratification of gallbladder polyps larger than 10 mm using high-resolution ultrasonography and texture analysis. Eur Radiol 28, 196–205 (2018). https://doi.org/10.1007/s00330-017-4954-1

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  • DOI: https://doi.org/10.1007/s00330-017-4954-1

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