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Differential diagnosis of gallbladder polypoid lesions using contrast-enhanced ultrasound

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Abstract

Purpose

The purpose of the study is to evaluate the utility of contrast-enhanced ultrasound (CEUS) for the differential diagnosis of gallbladder polypoid lesions (GPLs).

Methods

Thirty-six patients with GPLs (17 with gallbladder cancer, 19 with benign polyps) who underwent CEUS were enrolled in the study. The mean age of patients was 65.7 ± 12.6 years. Perflubutane-based contrast agent and high-mechanical index mode, which can eliminate the background B-mode and provide precise visualization of tumor vessels, were used for CEUS, and two blinded readers evaluated the images, retrospectively.

Results

Patient age and size of malignant GPLs (72.4 ± 9.4 years and 23.4 ± 7.5 mm) were significantly greater than those for benign lesions (59.6 ± 12.3 years and 12.4 ± 2.9 mm) (P < 0.01, respectively), and the receiver operating characteristic analysis showed the cut-off value as over 65 years and 16 mm. Univariate analysis showed that heterogeneity in B-mode (80% [12/15]), sessile shape (76% [13/17]), dilated vessel (71% [12/17]), irregular vessel (82% [14/17]), and heterogeneous enhancement (59% [10/17]) on CEUS were significantly correlated with malignant GPLs (P < 0.01, respectively). On CEUS, the diagnostic criterion for malignant GPLs was defined as having one or more of the above four features because of the highest accuracy. Sensitivity, specificity, and accuracy for malignant GBLs were 88%, 68%, and 78% for patient age; 76%, 89%, and 83% for size of GPLs; 80%, 68%, and 74% for B-mode; and 94%, 89%, and 92% for CEUS, respectively.

Conclusions

CEUS is useful for the differential diagnosis of malignant and benign GPLs.

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Funding

The present study did not receive any funding support.

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Authors and Affiliations

  1. Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan

    Haruo Miwa, Kazushi Numata, Kazuya Sugimori, Katsuyuki Sanga, Akane Hirotani, Shun Tezuka, Yoshihiro Goda, Kuniyasu Irie, Tomohiro Ishii, Takashi Kaneko & Katsuaki Tanaka

  2. Division of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Shin Maeda

Authors
  1. Haruo Miwa
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  2. Kazushi Numata
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  3. Kazuya Sugimori
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  4. Katsuyuki Sanga
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  5. Akane Hirotani
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  6. Shun Tezuka
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  7. Yoshihiro Goda
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  8. Kuniyasu Irie
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  9. Tomohiro Ishii
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  10. Takashi Kaneko
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  11. Katsuaki Tanaka
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  12. Shin Maeda
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Corresponding author

Correspondence to Kazushi Numata.

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Conflict of interest

All authors declare relevant conflicts of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Yokohama City University Certified Institutional Review Board.

Informed consent

Informed consent was obtained from individual participants included in the study.

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Miwa, H., Numata, K., Sugimori, K. et al. Differential diagnosis of gallbladder polypoid lesions using contrast-enhanced ultrasound. Abdom Radiol 44, 1367–1378 (2019). https://doi.org/10.1007/s00261-018-1833-4

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  • DOI: https://doi.org/10.1007/s00261-018-1833-4

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