Diagnostic accuracy of transabdominal high-resolution US for staging gallbladder cancer and differential diagnosis of neoplastic polyps compared with EUS.
OBJECTIVE
To compare the diagnostic accuracy of transabdominal high-resolution ultrasound (HRUS) for staging gallbladder cancer and differential diagnosis of neoplastic polyps compared with endoscopic ultrasound (EUS) and pathology.


METHODS
Among 125 patients who underwent both HRUS and EUS, we included 29 pathologically proven cancers (T1 = 7, T2 = 19, T3 = 3) including 15 polypoid cancers and 50 surgically proven polyps (neoplastic = 30, non-neoplastic = 20). We reviewed formal reports and assessed the accuracy of HRUS and EUS for diagnosing cancer as well as the differential diagnosis of neoplastic polyps. Statistical analyses were performed using chi-square tests.


RESULTS
The sensitivity, specificity, PPV, and NPV for gallbladder cancer were 82.7 %, 44.4 %, 82.7 %, and 44 % using HRUS and 86.2 %, 22.2 %, 78.1 %, and 33.3 % using EUS. HRUS and EUS correctly diagnosed the stage in 13 and 12 patients. The sensitivity, specificity, PPV, and NPV for neoplastic polyps were 80 %, 80 %, 86 %, and 73 % using HRUS and 73 %, 85 %, 88 %, and 69 % using EUS. Single polyps (8/20 vs. 21/30), larger (1.0 ± 0.28 cm vs. 1.9 ± 0.85 cm) polyps, and older age (52.5 ± 13.2 vs. 66.1 ± 10.3 years) were common in neoplastic polyps (p < 0.05).


CONCLUSIONS
Transabdominal HRUS showed comparable accuracy for diagnosing gallbladder cancer and differentiating neoplastic polyps compared with EUS. HRUS is also easy to use during our routine ultrasound examinations.


CONCLUSIONS
• HRUS showed comparable diagnostic accuracy for GB cancer compared with EUS. • HRUS and EUS showed similar diagnostic accuracy for differentiating neoplastic polyps. • Single, larger polyps and older age were common in neoplastic polyps. • HRUS is less invasive compared with EUS.
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.
Jeong Sub
JS
Lee
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. jhkim2008@gmail.com.|Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul, 110-744, Korea. jhkim2008@gmail.com.
Jung Hoon
JH
Kim
Department of Radiology, Soonchunhyang University Bucheon Hospital, 657 Hannam-Dong, Youngsan-Ku, Seoul, 140-743, Korea.
Yong Jae
YJ
Kim
Division of Gastroenterology, Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul, 110-744, South Korea.
Ji Kon
JK
Ryu
Division of Gastroenterology, Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul, 110-744, South Korea.
Yong-Tae
YT
Kim
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.|Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul, 110-744, Korea.
Jae Young
JY
Lee
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.|Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul, 110-744, Korea.
Joon Koo
JK
Han
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis; D005706:Gallbladder Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011127:Polyps / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis*; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*
Diagnosis; Endoscopic ultrasound; Gallbladder cancer; Gallbladder polyp; High-resolution ultrasound