European Radiology

, Volume 28, Issue 5, pp 1994–2002 | Cite as

The efficacy of real-time colour Doppler flow imaging on endoscopic ultrasonography for differential diagnosis between neoplastic and non-neoplastic gallbladder polyps

  • Su Young Kim
  • Jae Hee ChoEmail author
  • Eui Joo Kim
  • Dong Hae Chung
  • Kun Kuk Kim
  • Yeon Ho Park
  • Yeon Suk Kim



We evaluated the usefulness of real-time colour Doppler flow (CDF) endoscopic ultrasonography (EUS) for differentiating neoplastic gallbladder (GB) polyps from non-neoplastic polyps.


Between August 2014 and December 2016, a total of 233 patients with GB polyps who underwent real-time CDF-EUS were consecutively enrolled in this prospective study. CDF imaging was subjectively categorized for each patient as: strong CDF pattern, weak CDF pattern and no CDF pattern.


Of the 233 patients, 115 underwent surgical resection. Of these, there were 90 cases of non-neoplastic GB polyps and 23 cases of neoplastic GB polyps. In a multivariate analysis, a strong CDF pattern was the most significant predictive factor for neoplastic polyps; sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 52.2 %, 79.4 %, 38.7 %, 86.9 % and 73.9 %, respectively. Solitary polyp and polyp size were associated with an increased risk of neoplasm.


The presence of a strong CDF pattern as well as solitary and larger polyps on EUS may be predictive of neoplastic GB polyps. As real-time CDF-EUS poses no danger to the patient and requires no additional equipment, it is likely to become a supplemental tool for the differential diagnosis of GB polyps.

Key points

• Differential diagnosis between neoplastic polyps and non-neoplastic polyps of GB is limited.

• The use of real-time CDF-EUS was convenient, with high agreement between operators.

• The real-time CDF-EUS is helpful in differential diagnosis of GB polyps.


Endosonography Gallbladder Polyps Colour Doppler flow Neoplasm 



Colour Doppler flow


Contrast-enhanced harmonic EUS


Confidence interval


Endoscopic ultrasonography




Negative predictive value


Odds ratio


Positive predictive value


Standard deviation


Compliance with ethical standards


The scientific guarantor of this publication is Dong Kyun Park

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• prospective

• diagnostic or prognostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Su Young Kim
    • 1
  • Jae Hee Cho
    • 1
    Email author
  • Eui Joo Kim
    • 1
  • Dong Hae Chung
    • 2
  • Kun Kuk Kim
    • 3
  • Yeon Ho Park
    • 3
  • Yeon Suk Kim
    • 1
  1. 1.Division of Gastroenterology, Department of Internal MedicineGachon University, Gil Medical CenterIncheonRepublic of Korea
  2. 2.Department of PathologyGachon University, Gil Medical CenterIncheonRepublic of Korea
  3. 3.Department of SurgeryGachon University, Gil Medical CenterIncheonRepublic of Korea

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