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Utility of transabdominal ultrasound for surveillance of known pancreatic cystic lesions: prospective evaluation with MRI as reference standard

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Abstract

Objectives

To prospectively assess the utility of transabdominal ultrasound in surveillance of known pancreatic cystic lesions (PCL) using same day MRI as reference standard.

Methods

In an IRB-approved study with written informed consent, patients with known PCL underwent pancreas US on same day as surveillance MRI. US was performed blinded to same date MRI results. Transverse (TR), antero-posterior (AP), cranio-caudal (CC), and longest any plane diameter, were measured for each PCL at US and MRI. Visualization was correlated with patient (weight, abdominal diameter, thickness of abdominal fat, sex) and cyst (location, size, internal complexity) factors.

Results

252 PCLs evaluated in 57 subjects (39 females; mean age 67 (range 39–86) yrs). Mean maximum PCL diameter 8.5 (range 2–92) mm. US identified 100% (5/5) of cysts ≥3 cm; 92% (12/13) ≥2 and <3 cm; 78% (43/55) ≥1 and <2 cm; 35% (27/78) ≥5 mm and <1 cm; and 16% (16/101) <5 mm. US visualization correlated with PCL location (<0.0001), size (p < 0.0001), patient gender (p = 0.005), participation of attending radiologist (p = 0.03); inversely with patient weight (p = 0.012) and AP abdominal diameter (p = 0.01).

Conclusion

Many PCLs are visualized and accurately measured at follow-up with transabdominal ultrasound. Visualization correlates with lesion size, location, patient sex, weight, and abdominal diameter.

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Acknowledgements

The authors would like to acknowledge Laurie Sammons, RDMS and Lisa Napolitano, RDMS, for assistance with ultrasound examinations, as well as Lauren O’Loughlin, Bridget Giarusso, Amy Callahan, and Kelly Roth, for administrative support.

Author information

Author notes

  1. Corinne D. Strickland

    Present address: Radiology Ltd, 677 N. Wilmot Road, Tucson, AZ, 85711, USA

  2. Bahar Tamjeedi

    Present address: , 80 Marine Parade Drive, #424, Toronto, ON, M8V 0A3, Canada

Authors and Affiliations

  1. Lowell General Hospital, 295 Varnum Avenue, Lowell, MA, 01854, USA

    Maryellen R. M. Sun

  2. Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA

    Alexander Brook & Koenraad J. Mortele

  3. Beth Israel Deaconess Medical Center, Rosenberg 372, One Deaconess Road, Boston, MA, 02215, USA

    Olga R. Brook, Robert A. Kane & Bettina Siewert

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  1. Maryellen R. M. Sun
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Correspondence to Maryellen R. M. Sun.

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No grants or funding were associated with this study.

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There are no disclosures relevant to the content of this manuscript.

Appendices

Appendix 1

See Fig. 9.

Fig. 9
figure 9

US machines and transducers used. Initial scanning was performed with curvilinear array 5-1 MHz transducers on IU-22 units, and with C9-2 transducers on EPIQ units; additional linear array (L9-3 and L12-5) and sector (S4-1) transducers, could be subsequently utilized per operator discretion. US unit selection was based upon the site of service and availability of machines

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Appendix 2

See Table 2.

Table 2 Sequence parameters for MR examinations
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Sun, M.R.M., Strickland, C.D., Tamjeedi, B. et al. Utility of transabdominal ultrasound for surveillance of known pancreatic cystic lesions: prospective evaluation with MRI as reference standard. Abdom Radiol 43, 1180–1192 (2018). https://doi.org/10.1007/s00261-017-1269-2

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  • DOI: https://doi.org/10.1007/s00261-017-1269-2

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