Management of Incidental Pancreatic Cysts: A White Paper of the ACR Incidental Findings Committee

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2017.03.010 Byline: Alec J. Megibow (a), Mark E. Baker (b), Desiree E. Morgan (c), Ihab R. Kamel (d), Dushyant V. Sahani (e), Elliot Newman (f), William R. Brugge (g), Lincoln L. Berland (c), Pari V. Pandharipande (e)(h) Abstract: 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. Author Affiliation: (a) Department of Radiology, NYU-Langone Medical Center, New York, New York (b) Department of Radiology, Cleveland Clinic, Cleveland, Ohio (c) Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama (d) Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland (e) Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts (f) Department of Surgery, NYU-Langone Medical Center, New York, New York (g) Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts (h) Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts Article Note: (footnote) Dr. Megibow has nothing to disclose. Dr. Baker has nothing to disclose. Dr. Morgan reports grants from GE Healthcare, personal fees from GE Healthcare, outside the submitted work. Dr. Kamel has nothing to disclose. Dr. Sahani reports grants from GE Healthcare, textbook royalties from Elsevier, outside the submitted work. Dr. Newman has nothing to disclose. Dr. Brugge has nothing to disclose. Dr. Berland reports personal fees from Nuance Communications, Inc., outside the submitted work. Dr. Pandharipande reports a research grant from the Medical Imaging and Technology Alliance, outside the submitted work.