title: Hypoechoic foci on EUS are simple and strong predictive factors for neoplastic gallbladder polyps.
abstract: 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.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cho
authors.forename: Jeong Youp
authors.initials: JY
authors.lastname: Park
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Hee Man
authors.initials: HM
authors.lastname: Kim
authors.forename: Hong Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Hong
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Jae Bock
authors.initials: JB
authors.lastname: Chung
authors.forename: Si Young
authors.initials: SY
authors.lastname: Song
authors.forename: Seungmin
authors.initials: S
authors.lastname: Bang
mesh_terms: 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