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KMID : 0880420170180060915
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Korean Journal of Radiology
2017 Volume.18 No. 6 p.915 ~ p.925
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Incidental, Small (< 3 cm), Unilocular, Pancreatic Cysts: Factors That Predict Lesion Progression during Imaging Surveillance
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Kim Go-Eun
Shin Sang-Soo
Kim Jin-Woong
Heo Suk-Hee
Lim Hyo-Soon
Jun Chung-Hwan
Jeong Yong-Yeon
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Abstract
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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.
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KEYWORD
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Pancreas, Cyst, Follow-up, Surveillance, Cancer, Predictor, Prediction, Risk factor
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