Prevalence and Size-Based Risk Categorization of Pancreatic Cysts Among Asymptomatic Individuals With Screening MRI

What is the prevalence of clinically relevant pancreatic cystic lesions (PCLs) among asymptomatic adults who undergo screening with whole-body magnetic resonance imaging (MRI)?In this cross-sectional study of 21 651 North American individuals with whole-body MRI screening, the standardized prevalence of PCLs was 6% overall and 21% in individuals 80 years and older. Older age, female sex, history of pancreatitis and pancreatic ductal adenocarcinoma, family history of pancreatic ductal adenocarcinoma, alcohol use, and Latin American or Middle Eastern ethnicity were associated with higher likelihood of cyst development; 99% of lesions fell below the size threshold associated with a worrisome feature of increased malignant potential (3 cm).These findings suggest that most incidental PCLs, while common, may be very low risk based on size-based risk categorization alone.

Corresponding Author: Ajay V. Maker, MD, Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, 550 16th St, San Francisco, CA 94158 (ajay.maker@ucsf.edu).

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