title: Evaluation of the Sendai and 2012 International Consensus Guidelines based on cross-sectional imaging findings performed for the initial triage of mucinous cystic lesions of the pancreas: a single institution experience with 114 surgically treated patients.
abstract: BACKGROUND
  The Sendai Consensus Guidelines (SCG) were formulated in 2006 to guide the management of mucinous cystic lesions of the pancreas (CLPs) and were updated in 2012 (International Consensus Guidelines, ICG 2012). This study aims to evaluate the clinical utility of the ICG 2012 with the SCG based on initial cross-sectional imaging findings.
  
  
  METHODS
  One hundred fourteen patients with mucinous CLPs were reviewed and classified according to the ICG 2012 as high risk (HR(ICG2012)), worrisome (W(ICG2012)), and low risk (LR(ICG2012)), and according to the SCG as high risk (HR(SCG)) and low risk (LR(SCG)).
  
  
  RESULTS
  On univariate analysis, the presence of symptoms, obstructive jaundice, elevated serum carcinoembryonic antigen (CEA)/carbohydrate antigen (CA)19-9, solid component, main pancreatic duct ≥ 10 mm, and main pancreatic duct ≥ 5 mm was associated with high grade dysplasia/invasive carcinoma in all mucinous CLPs. Increasing number of HR(SCG) or HR(ICG2012) features was associated with a significantly increased likelihood of malignancy. The positive predictive value of HR(SCG) and HR(ICG2012) for high grade dysplasia/invasive carcinoma was 46% and 62.5% respectively. The negative predictive value of both LR(SCG) and LR(ICG2012) was 100%.
  
  
  CONCLUSIONS
  Both the guidelines were useful in the initial cross-sectional imaging evaluation of mucinous CLPs. The ICG 2012 guidelines were superior to the SCG guidelines.
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Division of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore. Electronic address: bsgkp@hotmail.com.
authors: Brian K P
authors: BK
authors: Goh
authors: Department of Oncologic Imaging, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.
authors: Choon-Hua
authors: CH
authors: Thng
authors: Department of Gastroenterology and Hepatology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors: Damien M Y
authors: DM
authors: Tan
authors: Department of Radiology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors: Albert S C
authors: AS
authors: Low
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Division of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors: Jen-San
authors: JS
authors: Wong
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Division of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors: Peng-Chung
authors: PC
authors: Cheow
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Division of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore.
authors: Pierce K H
authors: PK
authors: Chow
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Division of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors: Alexander Y F
authors: AY
authors: Chung
authors: Department of General Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors: Wai-Keong
authors: WK
authors: Wong
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Division of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore.
authors: London L P J
authors: LL
authors: Ooi
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: Cystic lesion of the pancreas; Guidelines; Intraductal papillary mucinous neoplasm; Pancreatic cyst; Pancreatic cystic neoplasm