Management of Incidental Pancreatic Cysts: A White Paper of the ACR Incidental Findings Committee.
J Am Coll Radiol. 2017 Jul;14(7):911-923. doi: 10.1016/j.jacr.2017.03.010. Epub 2017 May 19. Megibow AJ1, Baker ME2, Morgan DE3, Kamel IR4, Sahani DV5, Newman E6, Brugge WR7, Berland LL3, Pandharipande PV8.
The ACR Incidental Findings Committee (IFC) presents recommendations for managing pancreatic cysts that are incidentally detected on CT or MRI. These recommendations represent an update from the pancreatic component of the JACR 2010 white paper on managing incidental findings in the adrenal glands, kidneys, liver, and pancreas. The Pancreas Subcommittee-which included abdominal radiologists, a gastroenterologist, and a pancreatic surgeon-developed this algorithm. The recommendations draw from published evidence and expert opinion, and were finalized by informal iterative consensus. Algorithm branches successively categorize pancreatic cysts based on patient characteristics and imaging features. They terminate with an ascertainment of benignity and/or indolence (sufficient to discontinue follow-up), or a management recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. Our goal is to improve quality of care by providing guidance on how to manage incidentally detected pancreatic cysts.