Ultrasound Assessment of Size, Number Changes for Incidental Gallbladder Polyps

Leesburg, VA, September 22, 2021According to ARRS’ American Journal of Roentgenology (AJR), recent European multisociety guidelines proposing routine surveillance of essentially all gallbladder polyps, especially a 2 mm size change as the basis for cholecystectomy, are likely too conservative for clinical application.

“To our knowledge,” wrote corresponding author Aya Kamaya of Stanford Hospital and Clinics in California, “our study is the first conducted in the United States to longitudinally evaluate gallbladder polyps exclusively in patients with underlying liver disease.”

Kamaya and colleagues’ retrospective study included patients who underwent at least one screening ultrasound examination between January 2010 and December 2020, as part of a hepatocellular carcinoma (HCC) screening and surveillance program that demonstrated a gallbladder polyp.

Among the 434 patients (248 male, 186 female; mean age, 50.6 years) with incidental gallbladder polyps who underwent serial ultrasound examinations for HCC surveillance (range, 2–19 examinations; mean interval between first and last examinations, 3.6 years), the polyps fluctuated—increased and decreased on serial examinations—in number and size in 22% and 18% of patients, respectively. No gallbladder carcinoma was identified in the 19 patients who underwent cholecystectomy.

Acknowledging that gallbladder polyps can fluctuate in both size and number over serial examinations, and may even fluctuate in visibility, “using a 2 mm threshold for growth,” the authors of this AJR article concluded, “10% increased in size.”

Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiological society in North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress in medical imaging since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, AJR Live Webinars and Podcasts, topical symposia, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.