Pancreatic cystic neoplasms: a review of current recommendations for surveillance and management
Autor: | Raj Mohan Paspulati, Justin G. Yoon, Sree Harsha Tirumani, Daniel A. Smith, Nikhil H. Ramaiya, Vijayanadh Ojili |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Radiological and Ultrasound Technology business.industry Urology General surgery Risk of malignancy Gastroenterology Hepatology Neuroendocrine tumors medicine.disease 030218 nuclear medicine & medical imaging Disease course 03 medical and health sciences Serous fluid 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Internal medicine medicine Radiology Nuclear Medicine and imaging Cyst Pancreatic cysts Pancreas business |
Zdroj: | Abdominal Radiology. 46:3946-3962 |
ISSN: | 2366-0058 2366-004X |
Popis: | Pancreatic cystic neoplasms (PCN) comprise of a diverse array of pancreatic cysts, including intraductal papillary mucinous neoplasms (IPMN), mucinous cystic neoplasms (MCN), serous cystic neoplasms (SCN), cystic neuroendocrine tumors (cNET), and many others. Increasing use of cross-sectional imaging has resulted in greater numbers of PCNs discovered incidentally. The overall risk of malignancy is low, but can vary considerably between different classes of PCNs. Furthermore, many pancreatic cysts are indeterminate on imaging, and the inability to reliably predict the course of disease remains a challenge for radiologists. Due to the variability in disease course and a lack of high-quality studies on PCNs, there is no universal consensus when it comes to balancing optimal surveillance while avoiding the risk for overtreatment. Currently, there are three widely accepted international guidelines outlining guidelines for surveillance and management of PCNs: the American Gastroenterological Association (AGA) in 2015, the International Association of Pancreatology (IAP) last revised in 2017, and the European Study Group on Cystic Tumours of the Pancreas (European) last revised in 2018. In 2017, the American College of Radiology released its own comprehensive set of recommendations for managing indeterminate pancreatic cysts that are detected incidentally on CT or MRI. The purpose of this paper is to describe the key differences between the ACR recommendations and the aforementioned three sets of guidelines regarding cyst management, imaging surveillance, performance, and cost-effectiveness. |
Databáze: | OpenAIRE |
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