Early detection of gallbladder cancer: Current status and future perspectives

Table 5 Malignant characteristics of gall bladder polyp(s)

Modalities	Factors favoring malignant polyps	References
Clinical	Endemic areas, associated with PSC, old age > 60 years	[90-94]
USG	Single lobular surface, vascular core, hypo-echoic polyp and hypoechoic foci or a polyp size of greater than 1 cm, associated gall stones, sessile polyp, localized GB wall thickening, associated gall stone disease, focal gallbladder wall thickening > 4 mm, growth 2-4 mm/year	[92,95-99]
CEUS	Fast-in and “fast-out” enhancement pattern, hyper-enhancement in comparison to the GB wall in the arterial phase, wash-out time ≤ 40 seconds, GB wall destruction, and hepatic parenchymal infiltration, diffuse and branched types of contrast enhancement	[74,100]
CECT	Enhancement of polyp, mass filling GB lumen, liver infiltration, surrounding lymphadenopathy, associated asymmetric thickening,	[52]
PET scan	High SUV max	[89]

CECT: Contrast-enhanced computed tomography; USG: Ultrasonography; CEUS: Contrast-enhanced ultrasound; PET: Positron emission tomography; SUV: Standardized uptake value; GB: Gallbladder; RTE: Real-time elastography; PSC: Primary sclerosing cholangitis.