Society of Abdominal Radiology Disease Focused Panel Survey on Clinical Utilization of Incidental Pancreatic Cyst Management Recommendations and Template Reporting
J Am Coll Radiol . 2021 May 15;S1546-1440(21)00373-2. doi: 10.1016/j.jacr.2021.04.012. Online ahead of print.
Lyndon Luk, Elizabeth M Hecht, Stella Kang, Priya R Bhosale, Issac R Francis, Namita Gandhi, David M Hough, Gaurav Khatri, Alec Megibow, Desiree Morgan, Justin M Ream, Dushyant Sahani, Lewis K Shin, Vahid Yaghmai, Hanna Zafar, Atif Zaheer, Ravi Kaza
Objective: To assess current practice patterns with respect to protocols used for incidental pancreatic cyst follow-up, management guidelines, and template reporting.
Methods: The Society of Abdominal Radiology Disease Focused Panel on intraductal pancreatic neoplasms distributed an anonymous 14-question survey to its members in June 2018 that focused on current utilization of incidental pancreatic cyst guidelines, protocols, and template reporting.
Results: Among the 1,390 e-mail invitations, 323 responded and 94.7% (306 of 323) completed all questions. Respondents were mainly radiologists (93.8%, 303 of 323) from academic institutions (74.7%, 227 of 304) in North America (93.7%, 286 of 305). Of respondents, 42.5% (136 of 320) preferred 2017 ACR recommendations, 17.8% (57 of 320) homegrown systems, 15.0% (48 of 320) Fukuoka guidelines, and 7.8% (25 of 320) American Gastroenterological Association guidelines. The majority (68.7%, 222 of 323) agreed or strongly agreed that developing a single international consensus recommendation for management was important, and most radiologists preferred to include them in reports (231 of 322, 71.7%); yet only half included recommendations in >75% of reports (161 of 321). Magnetic resonance cholangiopancreatography was the modality of choice for follow-up of <2.5 cm cysts. Intravenous contrast was routinely used by 69.7% (212 of 304). Standardized reporting templates were rarely used in practice (12.8% 39 of 306).
Conclusions: Nearly 7 of 10 radiologists desire a unified international consensus recommendation for management of incidental cystic pancreatic lesions; ACR 2017 recommendations are most commonly used, followed by homegrown systems and Fukuoka guidelines. The majority of radiologists routinely use magnetic resonance cholangiopancreatography with intravenous contrast for follow-up of incidental cystic lesions, but template reporting is rarely used.
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