Effect of a region-wide incorporation of an algorithm based on the 2012 international consensus guideline on the practice pattern for the management of pancreatic cystic neoplasms in an integrated health system

Table 1 Radiology report: Southern California Permanente Medical Group Guideline for Imaging Management of Pancreatic Cysts (benign-appearing cyst in asymptomatic patient)

Size of Lesion	Recommendations
1-5 mm	Too small to characterize, considered benign
	No further imaging follow-up recommended
6-9 mm	Consider single follow-up in 2-3 yr, preferably MRCP/MRI pancreas
	If stable at follow up, no further imaging follow-up recommended
1-1.9 cm	Consider follow-up MRCP/MRI or CT pancreas in 1-2 yr
	If stable at follow-up, lengthen interval imaging follow-up to 2-3 yr
2-2.9 cm	Consider baseline EUS, then follow-up MRCP/MRI or CT pancreas in 6-12 mo
	Consider surgery in young, fit patients with need for prolonged surveillance
	If stable at follow-up, lengthen interval imaging follow-up to 1-2 yr
≥ 3 cm	Consider baseline or follow-up EUS, then follow-up MRCP/MRI or CT pancreas in 3-6 mo
	Strongly consider surgery in young, fit patients

MRCP: Magnetic resonance cholangiopancreatography; MRI: Magnetic resonance imaging; CT: Computed tomography; EUS: Endoscopic ultrasound.