Incidental, Small (< 3 cm), Unilocular, Pancreatic Cysts: Factors That Predict Lesion Progression during Imaging Surveillance.
10.3348/kjr.2017.18.6.915
- Author:
Go Eun KIM
1
;
Sang Soo SHIN
;
Jin Woong KIM
;
Suk Hee HEO
;
Hyo Soon LIM
;
Chung Hwan JUN
;
Yong Yeon JEONG
Author Information
1. Department of Radiology, Chonnam National University Hospital, Gwangju 61469, Korea.
- Publication Type:Original Article
- Keywords:
Pancreas;
Cyst;
Follow-up;
Surveillance;
Cancer;
Predictor;
Prediction;
Risk factor
- MeSH:
Christianity;
Dilatation;
Follow-Up Studies;
Humans;
Pancreas;
Pancreatic Cyst*;
Pancreatic Ducts;
Risk Factors;
Sensitivity and Specificity
- From:Korean Journal of Radiology
2017;18(6):915-925
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To explore the features that predict size increase and development of potential malignant features in incidentally detected, unilocular cystic pancreatic lesions (CPLs) less than 3 cm in diameter, during subsequent follow-up. MATERIALS AND METHODS: We retrieved data of patients diagnosed with unilocular CPLs less than 3 cm in diameter during the period from November 2003 through December 2014, using a computerized search. All serial CT and MR images were analyzed to identify the number, size, and location of CPLs; dilatation of the main pancreatic duct; and occurrence of worrisome features and high-risk stigmata of malignancy in the lesion. The characteristics of CPLs were compared between the increase (i.e., size increase during subsequent follow-up) and no-increase groups. For CPLs in the increase group, subgroup analysis was performed according to the lesion size at the last follow-up (< 3 cm vs. ≥ 3 cm). RESULTS: Among 553 eligible patients, 132 (23.9%) had CPLs that increased in size, and 421 (76.1%) had CPLs that did not, during follow-up. Of the 132, 12 (9.1%) CPLs increased to diameters ≥ 3 cm at the final follow-up. Among the various factors, follow-up duration was a significant independent factor for an interval size increase of CPLs (p < 0.001). In the increase group, initial cyst size was a significant independent factor to predict later size increase to or beyond 3 cm in diameter (p < 0.001), and the initial cyst diameter ≥ 1.5 cm predicted such a growth with a sensitivity and specificity of 83% and 72%, respectively. No significant factors to predict the development of potential malignant features were identified. CONCLUSION: Follow-up duration was associated with an interval size increase of CPLs. Among the growing CPLs, initial cyst size was associated with future lesion growth to and beyond 3 cm.
