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Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines

Due to the increasing use of cross-sectional imaging techniques and new technical possibilities, the number of incidentally detected cystic lesions of the pancreas is rapidly increasing in everyday radiological routines. Precise and rapid classification, including targeted therapeutic considerations...

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Autores principales: Kloth, Christopher, Haggenmüller, Benedikt, Beck, Annika, Wagner, Martin, Kornmann, Marko, Steinacker, Jochen P., Steinacker-Stanescu, Nora, Vogele, Daniel, Beer, Meinrad, Juchems, Markus S., Schmidt, Stefan A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914853/
https://www.ncbi.nlm.nih.gov/pubmed/36766560
http://dx.doi.org/10.3390/diagnostics13030454
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author Kloth, Christopher
Haggenmüller, Benedikt
Beck, Annika
Wagner, Martin
Kornmann, Marko
Steinacker, Jochen P.
Steinacker-Stanescu, Nora
Vogele, Daniel
Beer, Meinrad
Juchems, Markus S.
Schmidt, Stefan A.
author_facet Kloth, Christopher
Haggenmüller, Benedikt
Beck, Annika
Wagner, Martin
Kornmann, Marko
Steinacker, Jochen P.
Steinacker-Stanescu, Nora
Vogele, Daniel
Beer, Meinrad
Juchems, Markus S.
Schmidt, Stefan A.
author_sort Kloth, Christopher
collection PubMed
description Due to the increasing use of cross-sectional imaging techniques and new technical possibilities, the number of incidentally detected cystic lesions of the pancreas is rapidly increasing in everyday radiological routines. Precise and rapid classification, including targeted therapeutic considerations, is of essential importance. The new European guideline should also support this. This review article provides information on the spectrum of cystic pancreatic lesions, their appearance, and a comparison of morphologic and histologic characteristics. This is done in the context of current literature and clinical value. The recommendations of the European guidelines include statements on conservative management as well as relative and absolute indications for surgery in cystic lesions of the pancreas. The guidelines suggest surgical resection for mucinous cystic neoplasm (MCN) ≥ 40 mm; furthermore, for symptomatic MCN or imaging signs of malignancy, this is recommended independent of its size (grade IB recommendation). For main duct IPMNs (intraductal papillary mucinous neoplasms), surgical therapy is always recommended; for branch duct IPMNs, a number of different risk criteria are applicable to evaluate absolute or relative indications for surgery. Based on imaging characteristics of the most common cystic pancreatic lesions, a precise diagnostic classification of the tumor, as well as guidance for further treatment, is possible through radiology.
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spelling pubmed-99148532023-02-11 Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines Kloth, Christopher Haggenmüller, Benedikt Beck, Annika Wagner, Martin Kornmann, Marko Steinacker, Jochen P. Steinacker-Stanescu, Nora Vogele, Daniel Beer, Meinrad Juchems, Markus S. Schmidt, Stefan A. Diagnostics (Basel) Review Due to the increasing use of cross-sectional imaging techniques and new technical possibilities, the number of incidentally detected cystic lesions of the pancreas is rapidly increasing in everyday radiological routines. Precise and rapid classification, including targeted therapeutic considerations, is of essential importance. The new European guideline should also support this. This review article provides information on the spectrum of cystic pancreatic lesions, their appearance, and a comparison of morphologic and histologic characteristics. This is done in the context of current literature and clinical value. The recommendations of the European guidelines include statements on conservative management as well as relative and absolute indications for surgery in cystic lesions of the pancreas. The guidelines suggest surgical resection for mucinous cystic neoplasm (MCN) ≥ 40 mm; furthermore, for symptomatic MCN or imaging signs of malignancy, this is recommended independent of its size (grade IB recommendation). For main duct IPMNs (intraductal papillary mucinous neoplasms), surgical therapy is always recommended; for branch duct IPMNs, a number of different risk criteria are applicable to evaluate absolute or relative indications for surgery. Based on imaging characteristics of the most common cystic pancreatic lesions, a precise diagnostic classification of the tumor, as well as guidance for further treatment, is possible through radiology. MDPI 2023-01-26 /pmc/articles/PMC9914853/ /pubmed/36766560 http://dx.doi.org/10.3390/diagnostics13030454 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kloth, Christopher
Haggenmüller, Benedikt
Beck, Annika
Wagner, Martin
Kornmann, Marko
Steinacker, Jochen P.
Steinacker-Stanescu, Nora
Vogele, Daniel
Beer, Meinrad
Juchems, Markus S.
Schmidt, Stefan A.
Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines
title Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines
title_full Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines
title_fullStr Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines
title_full_unstemmed Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines
title_short Diagnostic, Structured Classification and Therapeutic Approach in Cystic Pancreatic Lesions: Systematic Findings with Regard to the European Guidelines
title_sort diagnostic, structured classification and therapeutic approach in cystic pancreatic lesions: systematic findings with regard to the european guidelines
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914853/
https://www.ncbi.nlm.nih.gov/pubmed/36766560
http://dx.doi.org/10.3390/diagnostics13030454
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