Diagnostic Value of Endoscopic Ultrasound Elastography and Contrast Enhanced Endoscopic Ultrasound for Differential Diagnosis of Gallbladder Polyp
Gallbladder polyps are often detected incidentally by ultrasonography. The most of gallbladder polyps are non-neoplastic such as cholesterol polyps and do not need further treatments. However, neoplastic polyps, which need additional treatments to prevent malignancy, show the same appearance on ultrasound. Clinically, the differential diagnosis between cholesterol polyps and adenomatous polyps is very important for patient follow-up and treatment. However, differential diagnosis between these two conditions is difficult using conventional trans-abdominal ultrasound.
Endoscopic ultrasound (EUS) is less affected and disturbed by subcutaneous fat or intraabdominal air, so a clearer image of pancreatobiliary system can be obtained. In addition, EUS elastography and contrast enhanced EUS are recently introduced. EUS elastography enables practitioners to evaluate the stiffness of a target lesion and compare it with surrounding tissues (strain ratio). Also, contrast enhanced EUS is used widely with additional information such as presence of vessels and enhancement pattern of soft tissues. Several studies have been published that EUS elastography can help in the differential diagnosis of pancreatic solid lesions.
Although studies have been conducted to confirm the usefulness of transabdomnial ultrasound with elastography or contrast enhancement at differentiating gallbladder polyps, no prospective studies have been conducted to evaluate the usefulness of EUS elastography or contrast enhanced EUS for gallbladder polyp. Therefore, with this prospective study, we would like to evaluate the diagnostic value of EUS elastography and contrast enhanced EUS for differential diagnosis of gallbladder polyps.
Study Overview
Status
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Sang Hyub Lee, MD., PhD.
- Phone Number: +082 2-2072-4892
- Email: gidoctor@snuh.org
Study Locations
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Seoul, Korea, Republic of, 101
- Recruiting
- Seoul National University Hospital
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Principal Investigator:
- Sang Hyub Lee, MD PhD
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Contact:
- Sang Hyub Lee, MD PhD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Gallbladder polyp of 8-10mm or more in size confirmed by imaging tests
- Must be 19 years old or older
- With voluntary agreement to participate in the study after be informed about the necessity of EUS due to the clinical necessity
Exclusion Criteria:
- Unable to confirm histological diagnosis (ex. Patients did not underwent cholecystectomy)
- Younger than 18 year-old
- Without agreement with this study or informed consent
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Pathologic diagnosis of gallbladder polyp after cholecystectomy
Time Frame: within 10 days after operation
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Pathologic diagnosis of gallbladder polyps or masses in cholecystectomy specimen
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within 10 days after operation
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Difference of strain ratio
Time Frame: Within two years of starting the study
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Differences in strain ratio between non-neoplastic and neoplastic gallbladder polyps.
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Within two years of starting the study
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Optimal cut-off valve of strain ratio
Time Frame: Within two years of starting the study
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Optimal cut-off valve of strain ratio for differential diagnosis between cholesterol polyps and adenomatous polyps
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Within two years of starting the study
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Diagnostic value of EUS-elastography
Time Frame: Within two years of starting the study
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Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EUS-elastography for diagnosis of cholesterol polyps.
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Within two years of starting the study
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Diagnostic value of contrast enhanced EUS
Time Frame: Within two years of starting the study
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Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of contrast enhanced EUS for diagnosis of cholesterol polyps.
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Within two years of starting the study
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Collaborators and Investigators
Publications and helpful links
General Publications
- Corwin MT, Siewert B, Sheiman RG, Kane RA. Incidentally detected gallbladder polyps: is follow-up necessary?--Long-term clinical and US analysis of 346 patients. Radiology. 2011 Jan;258(1):277-82. doi: 10.1148/radiol.10100273. Epub 2010 Aug 9.
- Park CH, Chung MJ, Oh TG, Park JY, Bang S, Park SW, Kim H, Hwang HK, Lee WJ, Song SY. Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography. Surg Endosc. 2013 Apr;27(4):1414-21. doi: 10.1007/s00464-012-2620-x. Epub 2012 Dec 12.
- Kozuka S, Tsubone N, Yasui A, Hachisuka K. Relation of adenoma to carcinoma in the gallbladder. Cancer. 1982 Nov 15;50(10):2226-34. doi: 10.1002/1097-0142(19821115)50:103.0.co;2-3.
- Sugiyama M, Atomi Y, Kuroda A, Muto T, Wada N. Large cholesterol polyps of the gallbladder: diagnosis by means of US and endoscopic US. Radiology. 1995 Aug;196(2):493-7. doi: 10.1148/radiology.196.2.7617866.
- Choi WB, Lee SK, Kim MH, Seo DW, Kim HJ, Kim DI, Park ET, Yoo KS, Lim BC, Myung SJ, Park HJ, Min YI. A new strategy to predict the neoplastic polyps of the gallbladder based on a scoring system using EUS. Gastrointest Endosc. 2000 Sep;52(3):372-9. doi: 10.1067/mge.2000.108041.
- Practical Guidelines for Management of Gallbladder Polyps. Korean Journal of HBP Surgery Vol. 14, No. 3, September 2010
- Wiles R, Thoeni RF, Barbu ST, Vashist YK, Rafaelsen SR, Dewhurst C, Arvanitakis M, Lahaye M, Soltes M, Perinel J, Roberts SA. Management and follow-up of gallbladder polyps : Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE). Eur Radiol. 2017 Sep;27(9):3856-3866. doi: 10.1007/s00330-017-4742-y. Epub 2017 Feb 9.
- Teber MA, Tan S, Donmez U, Ipek A, Ucar AE, Yildirim H, Aslan A, Arslan H. The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations. Med Ultrason. 2014 Dec;16(4):304-8. doi: 10.11152/mu.201.3.2066.164.1mat.
- Kitano M, Kudo M, Sakamoto H, Komaki T. Endoscopic ultrasonography and contrast-enhanced endoscopic ultrasonography. Pancreatology. 2011;11 Suppl 2:28-33. doi: 10.1159/000323493. Epub 2011 Apr 5.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-2005-135-1124
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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