When to stop surveillance of incidental pancreatic cysts in older adults: an expert review

The edition in brief

An American Gastroenterological Association expert review gives best-practice advice on stopping surveillance of incidental pancreatic cystic lesions in older adults, based on literature and expert opinion without formal evidence grading. It advises counselling against routine surveillance in people with significant comorbidity, considering stopping for stable small cysts after five years, and stopping hepatocellular carcinoma surveillance when life expectancy is under one to two years. A validation of Bone-RADS and OT-RADS on MRI in 80 children with solitary bone lesions found moderate agreement between five radiologists (kappa 0.470 and 0.432). A meta-analysis found diffusion MRI had pooled sensitivity 0.84 and specificity 0.57 for high-grade renal cell carcinoma, with radiomics and deep learning models reaching an AUC of 0.90 but varying between studies. A retrospective study of 92 intra-arterial liver procedures found a lower three-dimensional dose with angio-CT but no clear difference in total dose after uncertainty correction. A before-and-after study found that an electronic chat function cut telephone calls to the duty radiologist from 181 to 82 a day. The pearl covers what to include when reporting a pancreatic cyst.