Diagnostic accuracy of transabdominal high-resolution US for staging gallbladder cancer and differential diagnosis of neoplastic polyps compared with EUS
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.
Materials and 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.
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).
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.
• 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.
KeywordsHigh-resolution ultrasound Endoscopic ultrasound Gallbladder cancer Gallbladder polyp Diagnosis
We would like to thank Bonnie Hami, MA (USA), for her editorial assistance in the preparation of this manuscript.
The scientific guarantor of this publication is Joon Koo Han, MD. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Yong Jae Kim, MD, has significant statistical expertise and no complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained (IRB no. 1509-108-705). This retrospective study was approved by our institutional review board, and patient informed consent was waived.
Among 88 patients who were enrolled in our study, thirty-one patients have been previously reported in our previous paper published in AJR 2015; 204:W150–W159. However, the study purposes of these two studies were different. The previously published paper evaluated the accuracy of high-resolution sonography with combined low- and high-MHz transducers with that of conventional sonography for gallbladder cancer and polyps. However, the current study compares the diagnostic performance of transabdominal high-resolution ultrasound with endoscopic ultrasound.
Methodology: Retrospective, diagnostic study, performed at one institution.
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