Ultrasound Imaging Features Associated With Neoplastic Gallbladder Polyps: A Systematic Review and Meta-Analysis

Area of Science:

• Gastroenterology
• Medical Imaging
• Oncology

Background:

• Gallbladder polyps are common, with a subset being neoplastic and potentially malignant.
• Accurate differentiation of neoplastic from non-neoplastic polyps via imaging is crucial but challenging.

Purpose of the Study:

• To identify specific ultrasound (US) imaging features associated with neoplastic gallbladder polyps.
• To improve diagnostic accuracy for gallbladder polyps.

Main Methods:

• A meta-analysis of 30 studies involving 8,953 patients was conducted.
• Bivariate random-effects models were used to assess diagnostic performance of US features.
• Searched MEDLINE, EMBASE, Cochrane, and KoreaMed databases up to August 31, 2025.

Main Results:

• Eight of nine evaluated US features were significantly associated with neoplastic polyps.
• Key features include: size ≥10 mm, sessile morphology, single polyp, hypoechogenicity, gallbladder wall thickening (GBWT), and vascularity.
• Size ≥10 mm had the highest pooled sensitivity (0.79), while hypoechogenicity had the highest pooled specificity (0.93).

Conclusions:

• Several US imaging features are strongly linked to neoplastic gallbladder polyps.
• These identified features can assist clinicians in managing gallbladder polyps more effectively.
• Further research may refine diagnostic criteria for gallbladder polyps.