Cross sectional imaging of cystic pancreatic lesions: A systematic review

Abstract

s / Pancreatolog e18 potential and diagnosis of a cystic lesion can be reliably made using noninvasive methods. Methods: A search for relevant studies was performed using Medline and the Cochrane library using the search terms ‘pancreatic’, ‘pancreas’, ‘cyst’, ‘cystic’, ‘lesions’, ‘image’ and ‘imaging’. Publications were screened to include studies examining the performance of CT, MRI, MRCP and 18-FDG PET in the determination of benign of malignant cysts, cyst morphology and specific diagnoses. Results: Fourteen studieswere identified thatmet the inclusion criteria. 18-FDG PET had a sensitivity and sensitivity of 57.094.0% and 65.0-97.0% and an accuracy of 94% in determining between benign and malignant disease. CT had a sensitivity and specificity of 36.3-71.4% and 63.9-100% in determining benign disease but had an accuracy of making a specific diagnosis of 39.0-44.7%. MRI had a sensitivity and specificity of 91.4-100.0% and 89.7% in assessing for main pancreatic duct communication. Conclusion: CT is a good quality initial investigation to be used in conjunction with clinical information. In equivocal cases PET or MRI can add useful information including functionality or MDP communication but should be used judiciously. Take-home message: CT is a good quality initial investigation for identifying and assessing pancreatic cystic lesions. When futher information is necessary a PET or MRI can be useful. Abstract previously presented? no Any disclosures? no