Nearly 7 in 10 radiologists say they want unified international consensus recommendations for managing pancreatic lesions detected incidentally during imaging exams, according to survey results published Saturday.
Such asymptomatic cysts are spotted on 2.6% to 44.7% of abdominal CT and MRI exams, respectively, researchers explained in JACR. And while patients saddled with these findings undergo long-term follow-up, radiologists turn to a variety of published and homegrown protocols for guidance, including 2017 instructions from the American College of Radiology.
This lack of consensus is also reflected in daily reporting, as more than 60% never use structured templates for documenting incidental lesions. Most indicated they preferred to offer recommendations but said time constraints and a lack of well-established templates are holding them back.
“The data from this survey suggest that most radiologists would like to include management recommendations in their reports for the benefit of their referring clinicians but the lack of prospective data and interdisciplinary consensus limit the widespread adoption of the ACR recommendations or other previously published guidelines,” Lyndon Luk, MD, of New York Presbyterian-Columbia University Irving Medical Center’s Department of Radiology, and colleagues explained.
For their findings, Luk et al. sent a 14-question survey to members of the Society of Abdominal Radiology Disease Focused Panel for Intraductal Papillary Mucinous Neoplasms. Overall, response turnout was low as 323 of 1,390 potential participants completed the survey.
A majority (42.5%) of rads said they rely on 2017 ACR recommendations for managing incidental cystic pancreatic lesions, followed by homegrown systems (17.8%), Fukuoka guidelines (15%) and American Gastroenterological Association protocols (7.8%). Importantly, data assessing ACR recommendations in clinical practice are still lacking, the authors noted.
Furthermore, more than 68% “agreed” or “strongly agreed” that establishing an international consensus for these incidental findings is important. Seventy-one percent preferred to include them in their reports but only half did so in at least one-quarter of their documents. And standardized reporting was only used by 12% of rads.
Disease-specific templates may help bring consistency to interpretations and communication for referrers, and such resources have already proved useful for a number of other indications, including pancreatic adenocarcinoma, the authors noted.
“Although any standardized reporting template for incidental cystic pancreatic lesions should be time-efficient, referring clinicians would need to be involved in the design and implementation to facilitate widespread adoption,” Luk and co-authors concluded.
Read the entire report shared May 15 in the Journal of the American College of Radiology here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.