Pancreatic cysts: can surveillance interval for small low-risk lesions be lengthened?
Acta Radiol
; 65(5): 406-413, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38196245
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 ANDMETHODS:
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 <20â mm and ≥20â mm was performed.RESULTS:
A total of 270 patients were included (201 cysts <20â mm, 69 cysts ≥20â mm). Compared with cysts <20â mm, cysts ≥20â mm were more likely to be associated with WF or HRS (40.6% vs. 12.4%; P ≤0.00001), demonstrate increase in size of ≥5â 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 <20â mm have a low risk of developing WF and HRS and surveillance interval may be lengthened.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cisto Pancreático
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Imageamento por Ressonância Magnética
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Tomografia Computadorizada por Raios X
Tipo de estudo:
Etiology_studies
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Guideline
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Risk_factors_studies
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Screening_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article