title: Fate of small pancreatic cysts (<3 cm) after long-term follow-up: analysis of significant radiologic characteristics and proposal of follow-up strategies.
abstract: OBJECTIVE
  To describe the natural history of pancreatic cysts after long-term follow-up, with an emphasis on the identifying indicators of indolent lesions.
  
  
  METHODS
  We retrospectively sampled 95 patients with 149 cysts <3 cm detected by CT from 2003 to 2004, and followed them for more than five years (mean 117.5 ± 18.8 months). Two radiologists reviewed the initial CT images, then recorded changes after the follow-up. We compared the cysts' initial characteristics between the surgery and non-surgery patient groups, and also between non-benign lesions and benign lesions.
  
  
  RESULTS
  Twelve of the 95 patients, who among them had 16 cysts, underwent surgery. Of the 133 cysts in the 83 nonsurgical patients, 57 cysts (42.9 %) enlarged, although only five cysts increased to larger than 3 cm at the end of observation. The initial size of the cyst was significantly larger in the surgery group than non-surgery group. Also, according to cyst-based analysis, ductal communication, dilatation, and shape correlated with those of non-benign cysts and the non-surgical group. No cysts < 15 mm and without p-duct change showed a significant change within three years.
  
  
  CONCLUSIONS
  Small pancreatic cysts, without p-duct change, and without a pleomorphic or clubbed shape, may be followed for a longer interval than current consensus.
  
  
  CONCLUSIONS
  • Almost all small cysts < 3 cm were indolent in long term observation. • No cysts < 15 mm, without p-duct change showed significant change within 3 years. • Cyst size, ductal change and shape can be useful in predicting progress. • Only cysts with IPMN- like features and p-duct change need follow-up with cautions.
authors.affiliation: Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.
authors.forename: Heera
authors.initials: H
authors.lastname: Yoen
authors.affiliation: Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.|Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jung Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Su Joa
authors.initials: SJ
authors.lastname: Ahn
authors.affiliation: Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. hanjk@snu.ac.kr.|Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea. hanjk@snu.ac.kr.
authors.forename: Joon Koo
authors.identifier: http://orcid.org/0000-0001-5916-5545
authors.initials: JK
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Follow-up strategy; IPMN; Natural history; Pancreatic cyst; Radiologic characteristics