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Eur Radiol. 2018 Jan;28(1):196-205. doi: 10.1007/s00330-017-4954-1. Epub 2017 Jul 7.

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

Author information

1
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.
2
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. jhkim2008@gmail.com.
3
Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea. jhkim2008@gmail.com.
4
Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

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.

KEYWORDS:

Adenomatous polyp; Carcinoma; Gallbladder; Texture analysis; Ultrasound

PMID:
28687913
DOI:
10.1007/s00330-017-4954-1
[Indexed for MEDLINE]

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