The edition · Radiology
After five stable years, pancreatic cyst cancer risk stays below 1%
A 13,269-patient study finds the major cyst guidelines predict malignancy only modestly but agree on high-risk lesions, and stable low-risk cysts rarely turn; night shifts cut residents' chest film accuracy without slowing them; and obstetric ultrasound lawsuits turn on how reports communicate.
The edition in brief
A single-centre retrospective study of 13,269 patients with pancreatic cystic lesions found the Kyoto, ACR and European guidelines predicted five-year malignancy only modestly (AUROC 0.62–0.66) but agreed completely on high-risk lesions; after five years of imaging stability, eight-year cancer incidence was 0.71% overall and 0.46% in those meeting Kyoto criteria to stop surveillance. In a prospective reader study, six of ten radiology residents showed eye-tracking signs of fatigue after a night shift, and their chest radiograph accuracy fell (kappa 0.71 to 0.61) while reporting speed stayed the same; the AI tool tested did not restore accuracy. An AJR viewpoint on four obstetric ultrasound lawsuits found liability turned on whether reports communicated findings clearly, stated limitations and gave an actionable next step.
Obstetric ultrasound lawsuits turn on the report, not the diagnosis
Every obstetric ultrasound report should state its limitations and end with a clear, actionable next step.
After a night shift, chest film accuracy falls but reading speed does not
Treat post-night reporting as a patient-safety risk and build in safeguards; AI assistance did not offset fatigue here.
Report an incidental pancreatic cyst with the features that decide follow-up
Report size, duct diameter, mural nodule and interval growth for every pancreatic cyst.
Pancreatic cyst guidelines agree on high risk, and stable low-risk cysts rarely turn
For low-risk pancreatic cysts stable over five years and meeting Kyoto criteria, recommending an end to surveillance is reasonable.
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