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- Title
Pancreatic cysts: can surveillance interval for small low-risk lesions be lengthened?
- Authors
Chong, Jingli; Wee, Nicole Kessa; Tan, Cher Heng; Low, Hsien Min; Chew, Wei Da; Vu, Charles Kien Fong; Lee, Chau Hung
- Abstract
Background: Surveillance of pancreatic cysts are necessary due to risk of malignant transformation. However, reported progression rates to advanced neoplasia are variable and the high frequency of surveillance scans may pose a considerable burden on healthcare resources. Purpose: To validate the effectiveness of the Fukuoka Guidelines surveillance regime and determine if a longer surveillance interval can be established. Material and Methods: All magnetic resonance imaging (MRI) studies of the pancreas performed at our institution between January 2014 and December 2016 with at least one pancreatic cystic lesion and follow-up MRI or computed tomography (CT) over at least two years were reviewed for size, worrisome feature (WF), and high-risk stigmata (HRS) at diagnosis and follow-up imaging (up to year 6). Reference standards for advanced neoplasia were based on endoscopic ultrasound, fine needle aspiration cytology, or the presence of ≥2 WF or ≥1 HRS on imaging. Comparison of MRI features of progression and outcomes of diagnostic endpoints between lesions <20 mm and ≥20 mm was performed. Results: A total of 270 patients were included (201 cysts <20 mm, 69 cysts ≥20 mm). Compared with cysts <20 mm, cysts ≥20 mm were more likely to be associated with WF or HRS (40.6% vs. 12.4%; P ≤0.00001), demonstrate increase in size of ≥5 mm in two years (20.3% vs. 10.9%; P = 0.049), and develop advanced neoplasia (24.6% vs. 0.5%; P <0.00001). Conclusion: Pancreatic cysts <20 mm have a low risk of developing WF and HRS and surveillance interval may be lengthened.
- Subjects
PANCREATIC cysts; MAGNETIC resonance imaging; NEEDLE biopsy; ENDOSCOPIC ultrasonography; COMPUTED tomography
- Publication
Acta Radiologica, 2024, Vol 65, Issue 5, p406
- ISSN
0284-1851
- Publication type
Article
- DOI
10.1177/02841851231222799