Imaging based flowchart for gallbladder polyp evaluation

Abstract Background Preoperative differentiation between neoplastic and nonneoplastic gallbladder polyps, the subsequent indication for cholecystectomy remains a clinical dilemma. The current 1 cm size threshold neoplasia is unspecific. aim of this study was to improve diagnostic work-up polyps using sonographic MRI characteristics polyps. Methods A prospective, exploratory including patients undergoing polyp(s) conducted. Patients underwent targeted transabdominal ultrasound (TAUS) MRI. Outcomes were sensitivity specificity polyp diagnosis, radiological types. Histopathology after used as reference standard. Results demonstrated in 20/27 (74%): 14 cholesterol three adenomyomatosis, two adenomas one gastric heterotopia. Sensitivity identification 72% (routine TAUS) 86% (targeted TAUS MRI). Both identified on Sonographic presentation multiple, pedunculated either heterogeneous or with hyperechoic foci, single containing cysts limited On hyperintense T1-weighted image An adenoma high-grade dysplasia showed foci decreased ADC values. We propose checklist evaluation by flowchart Conclusions presented could aid compared routine ultrasound, elimination ultimately treatment decision