Dr. Young Koog Cheo and team at Chun Hyang University College of Medicine, Seoul reported that endoscopic approach may be superior to conventional ultrasound in such evaluation, but it is unable to differentially diagnose small polyps.

In the study, the researchers retrospectively analyzed data on 94 surgical patients with polyps of less than 20 mm in diameter, to compare the performance of these methods. Overall, the neoplastic polypoid lesions were 19. Endoscopic ultrasonography accurately differentiated 80.9%, compared to 63.9% with conventional ultrasound.

However, it was observed that the endoscopic approach detected 8 of 9 neoplastic lesions with a diameter of more than 1.0 cm (88.9%) but it spotted only 4 of the 10 (40%) with a lesser diameter.

Based on these results, the authors conclude that endoscopic ultrasound alone is not sufficient for determining a treatment strategy for neoplastic polypoid lesions of less than 1.0 cm.

They also suggested that patients with such small lesions should be followed by ultrasound at intervals of 6 to 12 months. Reinvestigation should be done for the changes in the size or structure with endoscopic ultrasound and lead physicians should consider cholecystectomy.