Overview and comparison of guidelines for management of pancreatic cystic neoplasms

Table 2 Approach to surveillance of pancreatic cysts without high risk or worrisome features at diagnosis

Size	IAP (Fukuoka) 2012	IAP (Fukuoka) 2017	ACG 2018	ACR 2018	European 2018	AGA 2015
< 1 cm	CT/MRI in 2-3 yr	CT/MRI in 6 mo then every 2 yr	MRI q 2 yr (lengthen after4)	MRI/CT q1 year for cysts < 1.5 cm and q6 mo for cysts 1.5-2.5 cm × 4 and then lengthen interval; stop after stability over 10 yr1	Surveillance q 6 mo × 2 with MRI and/or EUS, CA19-9; if stable lifelong surveillance is recommended with annual MRI/EUS, CA19-9	MRI in 1 yr, then every 2 for 5 yr Stop if stable
1-2 cm	CT/MRI annually × 2 yr, then lengthen interval if stable	CT/MRI in 6 m × 1 yr A Annually × 2 yr, then lengthen interval if stable	MRI q 1 yrs FOR 3 yr Then q 2 yr FOR 4 yr
2-3 cm	EUS in 3-6 mo, then lengthen interval, alternate MRI with EUS as appropriate	EUS in 3-6 mo, then lengthen interval, alternate MRI with EUS as appropriate	EUS/MRI q 6mo for 3 yr then yearly for 4 yr	For cysts > 2.5 cm q6 mo MRI/CT and then stop if stable for over 10 yr; for patients > 80 yr of age, q2 year imaging1
> 3 cm	Alternate MRI/EUS every 3-6 mo	Alternate MRI/EUS every 3-6 mo	EUS/MRI q 6mo for 3 yr then yearly for 4 yr

¹These guidelines use < 1.5 cm, 1.5-2.5 and > 2.5 as cut off values. CT: Computed tomography; MRI: magnetic resonance imaging; EUS: Endoscopic ultrasonography; ACG: American College of Gastroenterology; AGA: American Gastroenterological Association.