title: Fukuoka and AGA Criteria Have Superior Diagnostic Accuracy for Advanced Cystic Neoplasms than Sendai Criteria.
abstract: The aim of this study was to compare the American Gastroenterological Association guidelines (AGA criteria), the 2012 (Fukuoka criteria), and 2006 (Sendai criteria) International Consensus Guidelines for the diagnosis of advanced pancreatic cystic neoplasms.
  
  
  
  All patients who underwent surgical resection of a pancreatic cyst from August 2007 through January 2016 were retrospectively analyzed at a single tertiary academic center. Relevant clinical and imaging variables along with pathology results were collected to determine appropriate classification for each guideline. Advanced pancreatic cystic neoplasms were defined by the presence of either high-grade dysplasia or cystic adenocarcinoma. Diagnostic accuracy was measured by ROC analysis.
  
  
  
  A total of 209 patients were included. Both the AGA and Fukuoka criteria had a higher diagnostic accuracy for advanced neoplastic cysts than the Sendai criteria: AGA ROC 0.76 (95% CI 0.69-0.81), Fukuoka ROC 0.78 (95% CI 0.74-0.82), and Sendai ROC 0.65 (95% CI 0.61-0.69) (p < 0.0001). There was no difference between the Fukuoka and the AGA criteria. While the sensitivity was higher in the Fukuoka criteria compared to the AGA criteria (97.7 vs. 88.6%), the specificity was higher in the AGA criteria compared to the Fukuoka criteria (62.4 vs. 58.2%).
  
  
  
  In a surgical series of patients with pancreatic cysts, the AGA and Fukuoka criteria had superior diagnostic accuracy for advanced neoplastic cysts compared to the original Sendai criteria.
authors.affiliation: Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Sighinolfi
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Quan
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Ibaseta
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Pham
authors.affiliation: Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Monica M
authors.initials: MM
authors.lastname: Dua
authors.affiliation: Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: George A
authors.initials: GA
authors.lastname: Poultsides
authors.affiliation: Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Visser
authors.affiliation: Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Jeffery A
authors.initials: JA
authors.lastname: Norton
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. wgpark@stanford.edu.|Pancreas Clinic, Stanford University School of Medicine, 300 Pasteur Drive, MC: 5187, Stanford, CA, 94305, USA. wgpark@stanford.edu.
authors.forename: Walter G
authors.identifier: 0000-0001-8187-4188
authors.initials: WG
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000368:Aged; D003952:Diagnostic Imaging / Q000379:methods; D061827:Dimensional Measurement Accuracy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010180:Pancreatectomy / Q000379:methods / Q000706:statistics & numerical data; D010181:Pancreatic Cyst / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology
keywords: Guidelines; Intraductal papillary mucinous neoplasms; Mucinous cyst; Pancreatic cyst