Lyndon Luk MD, Presenter: Nothing to Disclose

Tamas Gonda, Abstract Co-Author: Nothing to Disclose

Maia Kayal, Abstract Co-Author: Nothing to Disclose

Elizabeth M. Hecht MD, Abstract Co-Author: Nothing to Disclose

Current literature provides limited information on the growth rate of asymptomatic cystic pancreatic lesions in patients that have had multiple abdominal MR studies over a period of at least four years. Demonstrating stability in these lesions over an extended period of time may further establish follow-up imaging guidelines.

Keyword search of radiology reports from 2009- 2013 was used to identify patients with cystic pancreatic lesions. Of the 803 patients identified, 58 had cystic lesions identifiable on MRI and >4 year imaging follow up. Two radiologists in consensus reviewed axial and coronal T2W images (5-8 mm slice thickness) and measured the single largest dimension of the largest pancreatic cystic lesion in each study. Mean interval and overall growth rate of these lesions were calculated and compared using t test (p< 0.05, significant).

58 (38F: 20M, mean age 62 y) patients with 58 target unilocular cystic lesions without wall thickening or internal nodularity ranging in size from 3-53 mm (mean 12.7 mm) underwent 370 abdominal MRI studies over a mean follow up of 79 months (range 48-160 mo, mean 6.4 MRI studies/patient). Of the 58 lesions, 7 had cytologic evidence of IPMN and 49 had no pathologic diagnosis. Only one patient proceeded to surgery after 8 year follow up because of developing main duct dilation and lesion growth from 17 mm to 30 mm. Pathology revealed partly high grade neoplasm without an invasive component. Mean overall growth of all lesions was 2.1 mm (16.5%). 27 patients had overall diameter growth of ≥ 3 mm. Among the lesions with ≥ 3 mm growth (range of growth 3-13 mm), there was no significant difference in baseline size compared to lesions that had no growth or < 3 mm growth (12.3 versus 13.4 mm). There was no interval development of wall thickening or internal nodularity within the target lesions in either group. 

58 asymptomatic unilocular cystic pancreatic lesions in this study followed for greater than 4 years up to 13 years demonstrated only 16.5% growth and only 1 lesion (1.7%) which demonstrated 76.5% growth combined with main duct dilation proceeded to surgery.

58 asymptomatic unilocular cystic pancreatic lesions in this study followed for greater than 4 years up to 13 years demonstrated only 16.5% growth and only 1 lesion (1.7%) which demonstrated 76.5% growth combined with main duct dilation proceeded to surgery.

Luk, L, Gonda, T, Kayal, M, Hecht, E, Natural History of Incidental Unilocular Cystic Pancreatic Lesions with >4 Year MRI Follow Up.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012157.html