ARRS 2022 Abstracts


E1284. Longitudinal Ultrasound Assessment of Incidentally Detected Gallbladder Polyps
  1. Andrew Walsh; Stanford Hospital and Clinics Department Of Radiology
  2. Aya Kamaya; Stanford Hospital and Clinics Department Of Radiology
The objective of this study was to evaluate the behavior of incidentally detected gallbladder polyps at ultrasound over time and compare to society guidelines based on size and change in size.

Materials and Methods:
All patients who had gallbladder polyps seen on ultrasound and enrolled in a hepatocellular carcinoma (HCC) screening program over an 11-year period were reviewed. Reports were retrospectively reviewed to determine the size and number of polyps and how they changed over time. Pathologic and clinical follow-up was obtained through the electronic medical record.

A total of 759 patients with 2395 ultrasound studies were identified in the HCC screening program who had gallbladder polyps between 2010 and 2020. There were 434 patients who had multiple studies, ranging from 2 to 19. The average number of studies per patient was 4.8 (range 2 to 19), with average time between the first and last of 3.6 ± 3.1 years (max 11.0). The average polyp size was 5 ± 2 mm (max 19 mm). There were 670 patients who had polyps = 6 mm, 70 patients had polyps 7–9 mm, and 19 patients had polyps = 0 mm. Of the 434 patients with more than one ultrasound, polyp size increased in 9.6%, decreased in 16.4%, and was fluctuant in 18.4%. For 9.2% of patients the polyp(s) disappeared permanently on follow-up, and 6.2% of patients had polyps that disappeared and subsequently reappeared on subsequent imaging. Nineteen patients underwent cholecystectomy, and none had gallbladder malignancy.

Incidental gallbladder polyps in patients undergoing HCC screening are fluctuant both in size and number over time. No gallbladder malignancies were identified in patients who were followed or underwent cholecystectomy. Current guidelines suggest frequent follow-up of small gallbladder polyps, which may not be suitable as incidental small polyps are fluctuant in size and number over time.