Application of Gallbladder Reporting and Data System (Gb-Rads) in Differentiating Benign and Malignant Gallbladder Lesions: A Systematic Review

Abstract

The Gallbladder Reporting and Data System (GB-RADS) was developed in 2022 to standardize ultrasonographic assessment of gallbladder lesions and stratify malignancy risk. This systematic review evaluates the diagnostic performance of GB-RADS in differentiating benign from malignant gallbladder lesions. We systematically searched PubMed, Cochrane Library, and ScienceDirect from January 2015 to September 2025. Studies evaluating GB-RADS diagnostic accuracy with histopathological confirmation were included. Quality assessment used the Newcastle-Ottawa Scale for cohort studies. Four studies comprising 820 patients met inclusion criteria. GB-RADS demonstrated variable diagnostic accuracy (71.7%-95.2%), with sensitivity ranging from 68.8% to 96.2% and specificity from 73.3% to 94.6%. Combination approaches (GB-RADS with Color Doppler Flow Imaging) showed superior performance (AUC 0.965). Risk stratification showed graduated malignancy rates across categories, with GB-RADS 5 lesions showing 79.8-89.1% malignancy rate. GB-RADS provides standardized risk stratification for gallbladder lesions with moderate to good diagnostic accuracy. However, validation studies remain extremely limited with only four published studies. Further large-scale multicenter prospective validation studies are urgently needed to establish its clinical utility in diverse populations.