OBJECTIVES: To examine the natural history of incidentally detected pancreatic cysts and whether a simplified MRI protocol without gadolinium is adequate for lesion follow-up. METHODS: Over a 10-year period, 301-patients with asymptomatic pancreatic cysts underwent follow-up (45 months ± 30). The magnetic resonance imaging (MRI) protocol included axial, coronal T2-weighted images, MR cholangiopancreatographic and fat suppressed T1-weighted sequences before and after gadolinium. Three radiologists independently reviewed the initial MRI, the follow-up studies using first only unenhanced images, then secondly gadolinium-enhanced-sequences. Lesion changes during follow-up were recorded and the added value of gadolinium-enhanced sequences was determined by classifying the lesions into risk categories. RESULTS: Three hundred and one patients (1,174 cysts) constituted the study population. Only 35/301 patients (12 %) showed significant lesion change on follow-up. Using multivariate analysis the only independent factor of lesion growth (OR = 2.4; 95 % CI, 1.7-3.3; P < 0.001) and mural nodule development (OR = 1.9; 95 % CI, 1.1-3.4, P = 0.03) during follow-up was initial lesion size. No patient with a lesion initial size less than 2 cm developed cancer during follow-up. Intra-observer agreement with and without gadolinium enhancement ranged from 0.86 to 0.97. After consensus review of discordant cases, gadolinium-enhanced sequences demonstrated no added value. CONCLUSION: Most incidental pancreatic cystic lesions did not demonstrate change during follow-up. The addition of gadolinium-enhanced-sequences had no added-value for risk assignment on serial follow-up. KEY POINTS: Significant growth of pancreatic cysts occurred in a minority of patients only. No lesion <2 cm demonstrated any change during the first year of follow-up. Intra-observer agreement between MR pancreatic protocols with and without gadolinium was excellent. Gadolinium application had limited value for follow-up of asymptomatic pancreatic cystic lesions.
OBJECTIVES: To examine the natural history of incidentally detected pancreatic cysts and whether a simplified MRI protocol without gadolinium is adequate for lesion follow-up. METHODS: Over a 10-year period, 301-patients with asymptomatic pancreatic cysts underwent follow-up (45 months ± 30). The magnetic resonance imaging (MRI) protocol included axial, coronal T2-weighted images, MR cholangiopancreatographic and fat suppressed T1-weighted sequences before and after gadolinium. Three radiologists independently reviewed the initial MRI, the follow-up studies using first only unenhanced images, then secondly gadolinium-enhanced-sequences. Lesion changes during follow-up were recorded and the added value of gadolinium-enhanced sequences was determined by classifying the lesions into risk categories. RESULTS: Three hundred and one patients (1,174 cysts) constituted the study population. Only 35/301 patients (12 %) showed significant lesion change on follow-up. Using multivariate analysis the only independent factor of lesion growth (OR = 2.4; 95 % CI, 1.7-3.3; P < 0.001) and mural nodule development (OR = 1.9; 95 % CI, 1.1-3.4, P = 0.03) during follow-up was initial lesion size. No patient with a lesion initial size less than 2 cm developed cancer during follow-up. Intra-observer agreement with and without gadolinium enhancement ranged from 0.86 to 0.97. After consensus review of discordant cases, gadolinium-enhanced sequences demonstrated no added value. CONCLUSION: Most incidental pancreatic cystic lesions did not demonstrate change during follow-up. The addition of gadolinium-enhanced-sequences had no added-value for risk assignment on serial follow-up. KEY POINTS: Significant growth of pancreatic cysts occurred in a minority of patients only. No lesion <2 cm demonstrated any change during the first year of follow-up. Intra-observer agreement between MR pancreatic protocols with and without gadolinium was excellent. Gadolinium application had limited value for follow-up of asymptomatic pancreatic cystic lesions.
Authors: Sang Hyub Lee; Cheol Min Shin; Joo Kyung Park; Sang Myung Woo; Ji Won Yoo; Ji Kon Ryu; Yong Bum Yoon; Yong-Tae Kim Journal: Dig Dis Sci Date: 2007-04-03 Impact factor: 3.199
Authors: Elizabeth M Hecht; Gaurav Khatri; Desiree Morgan; Stella Kang; Priya R Bhosale; Isaac R Francis; Namita S Gandhi; David M Hough; Chenchan Huang; Lyndon Luk; Alec Megibow; Justin M Ream; Dushyant Sahani; Vahid Yaghmai; Atif Zaheer; Ravi Kaza Journal: Abdom Radiol (NY) Date: 2020-11-13
Authors: Chiara Pozzessere; Sandra Luz Castaños Gutiérrez; Celia Pamela Corona-Villalobos; Lorenzo Righi; Chunmiao Xu; Anne Marie Lennon; Christopher L Wolfgang; Ralph H Hruban; Michael Goggins; Marcia I Canto; Ihab R Kamel Journal: J Comput Assist Tomogr Date: 2016 Jul-Aug Impact factor: 1.826
Authors: Alexis M Cahalane; Y M Purcell; L P Lavelle; S H McEvoy; E R Ryan; E O'Toole; D E Malone Journal: Eur Radiol Date: 2016-01-13 Impact factor: 5.315