Risk stratification of gallbladder polyps larger than 10 mm using high-resolution ultrasonography and texture analysis

Tae Won Choi, Jung Hoon Kim, Sang Joon Park, Su Joa Ahn, Ijin Joo, Joon Koo Han

Research output: Contribution to journalArticle

4 Scopus citations


Objectives: To assess important features for risk stratification of gallbladder (GB) polyps >10 mm using high-resolution ultrasonography (HRUS) and texture analysis. Methods: We included 136 patients with GB polyps (>10 mm) who underwent both HRUS and cholecystectomy (non-neoplastic, n = 58; adenomatous, n = 32; and carcinoma, n = 46). Two radiologists retrospectively assessed HRUS findings and texture analysis. Multivariate analysis was performed to identify significant predictors for neoplastic polyps and carcinomas. Results: Single polyp (OR, 3.680–3.856) and larger size (OR, 1.450–1.477) were independently associated with neoplastic polyps (p < 0.05). In a single or polyp >14 mm, sensitivity for differentiating neoplastic from non-neoplastic polyps was 92.3%. To differentiate carcinoma from adenoma, sessile shape (OR, 9.485–41.257), larger size (OR, 1.267–1.303), higher skewness (OR, 6.382) and lower grey-level co-occurrence matrices (GLCM) contrast (OR, 0.963) were significant predictors (p < 0.05). In a polyp >22 mm or sessile, sensitivity for differentiating carcinomas from adenomas was 93.5–95.7%. If a polyp demonstrated at least one HRUS finding and at least one texture feature, the specificity for diagnosing carcinoma was increased to 90.6–93.8%. Conclusion: In a GB polyp >10 mm, single and diameter >14 mm were useful for predicting neoplastic polyps. In neoplastic polyps, sessile shape, diameter >22 mm, higher skewness and lower GLCM contrast were useful for predicting carcinoma. Key Points: • Risk of neoplastic polyp is low in <14 mm and multiple polyps • A sessile polyp or >22 mm has increased risk for GB carcinomas • Higher skewness and lower GLCM contrast are predictors of GB carcinoma • HRUS is useful for risk stratification of GB polyps >1 cm

Original languageEnglish
Pages (from-to)196-205
Number of pages10
JournalEuropean Radiology
Issue number1
StatePublished - 1 Jan 2018


  • Adenomatous polyp
  • Carcinoma
  • Gallbladder
  • Texture analysis
  • Ultrasound

Cite this