Hypoechoic foci on EUS are simple and strong predictive factors for neoplastic gallbladder polyps.
BACKGROUND
EUS is an accurate imaging modality for delineating gallbladder (GB) structures; however, its clinical use in differentiating neoplastic GB polyps from nonneoplastic polyps is limited. Thus, we sought to characterize neoplastic GB polyps by analyzing unique EUS features. Our analysis revealed variably shaped, relatively hypoechoic portions in the core of polyps compared with general background echogenicity.


OBJECTIVE
Our purpose was to make a differential diagnosis between neoplastic and nonneoplastic GB polyps of less than 20 mm by use of EUS variables, including hypoechoic foci.


METHODS
Retrospective single-center study.


METHODS
University teaching hospital.


METHODS
Patients (n = 88) underwent preoperative EUS and cholecystectomy for GB polyps smaller than 20 mm.


RESULTS
Hypoechoic foci were found in 30 of 33 patients (91%) with neoplastic polyps and 6 of 55 (11%) with nonneoplastic polyps. In a multivariate analysis, hypoechoic foci were the only significant predictive factor for neoplastic polyps (odds ratio [OR] 55.4, 95% CI, 8.26-371, P < .001); the sensitivity and specificity were 90% and 89%, respectively. In addition, polyps >15 mm had an increased risk of malignancy (OR 21.7, 95% CI, 2.35-201, P = .007), as did those with hypoechoic foci (OR 10.9; 95% CI, 1.01-117, P = .049).


CONCLUSIONS
Retrospective review of selected patients from a tertiary medical center.


CONCLUSIONS
The presence of hypoechoic foci on EUS is a strong predictive factor for neoplastic polyps. EUS may be useful in developing a treatment strategy for GB polyps.
Cho
Jae Hee
JH
Division of Gastroenterology, Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.
Park
Jeong Youp
JY
Kim
Yoon Jae
YJ
Kim
Hee Man
HM
Kim
Hong Jeong
HJ
Hong
Sung Pil
SP
Park
Seung Woo
SW
Chung
Jae Bock
JB
Song
Si Young
SY
Bang
Seungmin
S
D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D019160:Endosonography; D005260:Female; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D012189:Retrospective Studies