Variability in measurements of pancreatic cyst size among EUS, CT, and magnetic resonance imaging modalities.
BACKGROUND
Cyst size is an important factor in the management of pancreatic cysts, both in predicting the need for surgery and the frequency of follow-up.


OBJECTIVE
To determine agreement and precision of EUS, CT, and magnetic resonance imaging (MRI) modalities in the evaluation of pancreatic cyst diameter.


METHODS
Retrospective chart review.


METHODS
Tertiary-care center, January 2000 to June 2009.


METHODS
This study involved 175 patients presenting for EUS evaluation of pancreatic cysts, with size measured by at least two of the aforementioned imaging studies within a 90-day period.


METHODS
Largest cyst diameter from EUS, CT, MRI/MRCP, and surgical pathology.


RESULTS
A total of 175 patients underwent EUS. Seventy-three had CT plus EUS, 33 had MRI/MRCP plus EUS, 23 had MRI/MRCP plus CT, and 15 had all imaging studies, occurring within 90 days of each other. Median size differences between studies: EUS and CT (ie, absolute value of size determined by EUS minus size determined by CT) = 4 mm (range 0-25 mm), EUS and MRI = 4 mm (range 0-17 mm), CT and MRI = 3 mm (range 2-20 mm). Median size differences for surgical pathology specimens compared with results of 12 EUS, 13 CT, and 8 MRI/MRCP studies were as follows: EUS and pathology = 9.5 mm (range 0-20 mm), CT and pathology = 5 mm (range 0-21 mm), MRI and pathology = 5.5 mm (range 2-44 mm).


CONCLUSIONS
Interobserver variability and small sample of surgical pathology cysts.


CONCLUSIONS
There is considerable variation in size estimates of pancreatic cysts by different imaging modalities, which practitioners should take into account when making management decisions. Use of a single imaging modality is recommended during follow-up. The precision of imaging studies for measuring pancreatic cysts must be prospectively defined if change in size is to be reliably used for clinical management.
Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio 44106, USA.
Santo
S
Maimone
Deepak
D
Agrawal
Michael J
MJ
Pollack
Richard C K
RC
Wong
Joseph
J
Willis
Ashley L
AL
Faulx
Gerard A
GA
Isenberg
Amitabh
A
Chak
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019160:Endosonography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed