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Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography: an international expert consensus

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A Letter to the Editor to this article was published on 21 January 2023

Abstract

The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0–5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management.

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Abbreviations

GB-RADS:

Gallbladder reporting and data system

US:

Ultrasound

GBC:

Gallbladder cancer

RAS:

Rokitansky-Aschoff sinuses

CBD:

Common bile duct

CT:

Computed tomography

MRI:

Magnetic resonance imaging

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Author information

Authors and Affiliations

  1. Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Pankaj Gupta, Pratyaksha Rana, Manphool Singhal, Ajay Gulati, Naveen Kalra, Raghuraman Soundararajan, Daneshwari Kalage, Manika Chhabra & Manavjit Singh Sandhu

  2. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Usha Dutta & Vishal Sharma

  3. Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Vikas Gupta, Thakur Deen Yadav & Harjeet Singh

  4. Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Lileshwar Kaman, Santosh Irrinki & Yashwant Sakaray

  5. Haematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Chandan Krishuna Das

  6. Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Uma Saikia & Ritambhara Nada

  7. Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Radhika Srinivasan

  8. Department of Radiology, All India Institute of Medical Education and Research, New Delhi, India

    Raju Sharma

  9. Department of Interventional Radiology, Tata Memorial Hospital, Mumbai, India

    Nitin Shetty

  10. Department of Radiodiagnosis, Christian Medical College, Vellore, India

    Anu Eapen

  11. Division of Diagnostic Imaging, Department of Abdominal Imaging, MD Anderson Cancer Centre, Houston, TX, USA

    Harmeet Kaur

  12. Abdominal Imaging, Harvard Medical School, Medical Director, Martha’s Vineyard Hospital Imaging, Massachusetts General Hospital, Boston, USA

    Avinash Kambadakone

  13. Radiology, University Medical Center Groningen, Groningen, The Netherlands

    Robbert de Haas

  14. HPB Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur, India

    Vinay K. Kapoor & Anu Behari

  15. Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia

    Savio George Barreto

  16. Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India

    Atul K. Sharma

  17. Indian Naval Hospital Ship, Asvini, Mumbai, India

    Amol Patel

  18. Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India

    Pramod Garg

  19. Surgical Gastroenterology, All India Institute of Medical Sciences, New Delhi, India

    Sujoy K. Pal

  20. Gastrointestinal and HPB Surgery, Tata Memorial Hospital, Mumbai, India

    Mahesh Goel & Shraddha Patkar

  21. GI Surgery and Liver Transplant, GB Pant Institute of Medical Education and Research and MAM College, New Delhi, India

    Anil K. Agarwal

  22. Medical Oncology, Apollo Proton Cancer Centre, Chennai, India

    Bhawna Sirohi

  23. Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Centre, Houston, USA

    Milind Javle

  24. HPB Surgery, University of Leicester, Leicester, UK

    Giuseppe Garcea

  25. Department of Gastroenterology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile

    Flavio Nervi

  26. Department of Pathology, Koc University Hospitals, Istanbul, Turkey

    Volkan Adsay

  27. Department of Pathology, Pontificia Universidad Catolica de Chile, Santiago, Chile

    Juan Carlos Roa

  28. Department of Surgery, College of Medicine, Seoul National University Bundang Hospital Seoul National University, Seongnam-si, South Korea

    Ho-Seong Han

Authors
  1. Pankaj Gupta
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  2. Usha Dutta
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  3. Pratyaksha Rana
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  38. Bhawna Sirohi
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  39. Milind Javle
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  40. Giuseppe Garcea
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  41. Flavio Nervi
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  42. Volkan Adsay
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  43. Juan Carlos Roa
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  44. Ho-Seong Han
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Contributions

PG, UD: Conceived and designed the work. PG, UD, PR, RS, DK, MC: Performed the systematic review of the literature. PG, UD, MS, NK, AG, VS, VG, TDY, CKD: Developed the first draft of survey statements. PG, UD, MS, AG, NK, VS, VG, TDY, LK, SI, HS, YS, CKD, US, RN, RS, MSS, RS, NS, AE, HK, AK, RdH, VKK, SGB, AKS, AP, PG, SKP, MG, SP, AB, AKG, BS, MJ, GG, FN, VA, JCR, HSH: Participated in the 1st, 2nd, and web-based rounds of the Delphi consensus and formulated the consensus statements. PG, UD, PR, RS, DK, MC: Wrote the initial draft. PG, UD, PR, MS, AG, NK, RS, DK, MC, VS, VG, TDY, LK, SI, HS, YS, CKD, US, RN, RS, MSS, RS, NS, AE, HK, AK, RdH, VKK, SGB, AKS, AP, PG, SKP, MG, SP, AB, AKG, BS, MJ, GG, FN, VA, JCR, HSH: Critically revised the manuscript, approved the final version of the manuscript submitted to the journal, and agree to be accountable for all aspects of the work.

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Correspondence to Pankaj Gupta.

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Gupta, P., Dutta, U., Rana, P. et al. Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography: an international expert consensus. Abdom Radiol 47, 554–565 (2022). https://doi.org/10.1007/s00261-021-03360-w

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