Evidence map›Paper›PMID 40856347›Full record

ArticleLiver international : official journal of the International Association for the Study of the Liver2025

Ultrasound for the Detection of Gallbladder Malignancy in Primary Sclerosing Cholangitis.

Johannes Altenmüller, Christiane Wiegard, Marcial Sebode, Ansgar W Lohse, Christina Villard, Stergios Kechagias, Emma Nilsson, Fredrik Rorsman, Hanns-Ulrich Marschall, Kalle Jokelainen and 3 more

Abstract readMulticenter Study
In one paragraph

Article in Liver international : official journal of the International Association for the Study of the Liver, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Ultrasound for the Detection of Gallbladder Malignancy in Primary Sclerosing Cholangitis.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Johannes AltenmüllerIst Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID 0009-0009-4796-8880
Christiane WiegardIst Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Marcial SebodeIst Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ansgar W LohseIst Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christina VillardEuropean Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.
Stergios KechagiasUnit of Internal Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Emma NilssonDepartment of Clinical Sciences, Lund University, Gastroenterology Clinic, Skåne University Hospital, Lund, Sweden.
Fredrik RorsmanDepartment of Gastroenterology and Hepatology, University Hospital, Uppsala, Sweden.
Hanns-Ulrich MarschallEuropean Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.
Kalle JokelainenEuropean Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.
Annika BergquistEuropean Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.
Martti FärkkiläEuropean Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.
Christoph SchrammIst Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Funding

Deutsche Forschungsgemeinschaft CRU306Hamburgischen Stiftung für Wissenschaften, Entwicklung und Kultur Helmut und Hannelore GreveYAEL Foundation
6 · The paper itself

Abstract

BACKGROUND AND

aimsIn primary sclerosing cholangitis (PSC), the risk for gallbladder malignancy is increased. Surveillance imaging is used for early diagnosis. The study aims to assess the reliability of ultrasound and magnetic resonance imaging (MRI) for the detection of gallbladder polyps in people with PSC and to define a polyp size as a cut-off at which cholecystectomy is indicated due to the high probability of a malignant finding.

methodsIn this retrospective European multicentre study, we included 51 people with PSC who had cholecystectomy for gallbladder polyps detected on imaging using ultrasound and/or MRI within 6 months prior to cholecystectomy and a histology report available. As a control group, we included 102 people with PSC with other indications for cholecystectomy. Malignancy was defined as high-grade dysplasia or carcinoma on histology.

resultsIncluding all 153 patients, ultrasound was significantly more sensitive than MRI in detecting gallbladder polyps (p < 0.001). MRI missed 3 of the 8 malignant polyps. Malignant polyps (n = 8, median size = 12.5 mm) were significantly larger than non-malignant polyps (n = 26, median size = 6 mm) on ultrasound (p < 0.001). Ultrasound detected malignant polyps reliably (AUC = 0.91, p < 0.001) with an optimal cut-off of 8 mm. This cut-off was defined in the Hamburg cohort and validated in a multicentre validation cohort with an AUC of 0.92 (p = 0.02).

conclusionsUltrasound is more sensitive for the detection of gallbladder polyps than MRI in people with PSC. The best cut-off to differentiate between benign and malignant polyps was 8 mm. Ultrasound (gallbladder) and MRI (bile ducts) may thus be complementary methods for hepatobiliary malignancy surveillance in people with PSC.

Indexed as

Cholangitis, SclerosingGallbladder NeoplasmsPolypsAdultAgedCholecystectomyEuropeFemaleGallbladderHumansMagnetic Resonance ImagingMaleMiddle AgedReproducibility of ResultsRetrospective StudiesSensitivity and SpecificitycholecystectomyimagingmalignancyPSC

Identifiers

PMID40856347
PMCPMC12379568

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.