Endoscopic ultrasonography does not differentiate neoplastic from non-neoplastic small gallbladder polyps

Area of Science:

• Gastroenterology
• Diagnostic Imaging
• Surgical Pathology

Background:

• Gallbladder polypoid lesions (PLGs) require accurate differentiation between neoplastic and non-neoplastic types.
• Accurate diagnosis is crucial for determining appropriate management and treatment strategies.

Purpose of the Study:

• To evaluate the diagnostic performance of endoscopic ultrasonography (EUS) in distinguishing neoplastic from non-neoplastic gallbladder polypoid lesions (PLGs).
• To compare the efficacy of EUS with transabdominal ultrasonography (US) for PLG characterization.

Main Methods:

• Retrospective analysis of 94 surgical cases involving gallbladder polyps less than 20 mm in diameter.
• Assessment of diagnostic accuracy for both EUS and transabdominal US in differentiating PLG types.

Main Results:

• EUS demonstrated higher overall diagnostic accuracy (80.9%) compared to US (63.9%) for small PLGs (P < 0.05).
• Neoplastic lesions prevalence increased with polyp size, ranging from 17.2% (5-10 mm) to 50% (16-20 mm).
• EUS accuracy was significantly lower for polyps < 1.0 cm (40%) compared to those > 1.0 cm (88.9%) (P = 0.02).

Conclusions:

• While EUS is superior to US for PLG differentiation, its accuracy for small lesions (< 1.0 cm) remains limited.
• EUS alone is insufficient for establishing treatment strategies for gallbladder polyps less than 1.0 cm.
• Further investigation or complementary diagnostic methods may be needed for small PLGs.