Transabdominal Ultrasound May Help Monitor Pancreatic Cysts

TOPLINE:

Transabdominal ultrasound (TAUS) demonstrated an 85.7% detection rate for cystic pancreatic lesions, which was also noted with endoscopic US (EUS), with BMI and lesion size significantly affecting the detection.

METHODOLOGY:

• Researchers conducted a retrospective analysis including 105 adult patients (median age, 69 years; 62.9% women) with cystic pancreatic lesions who underwent both EUS and TAUS examinations between January 2016 and June 2022 at a university hospital.
• In 83 patients, TAUS was the initial imaging method, followed by EUS after an average interval of 30 days, whereas in 22 patients, EUS served as the initial imaging method, followed by TAUS after an average interval of 73 days.
• EUS and TAUS images were reviewed by trained endoscopists, with morphologic evaluation depending on the specific criteria for differentiating non-suspicious and suspicious cystic pancreatic lesions.
• Multiple logistic regression analyses were implemented to evaluate patient characteristics and lesion-specific data to predict the detectability of cystic pancreatic lesions via TAUS.
• Lesion characteristics were also compared between the two methods using cross-method agreement.

TAKEAWAY:

• Cystic pancreatic lesions were detected using both EUS and TAUS in 90 patients (85.7%).
• Patients with undetectable lesions via TAUS showed a significantly higher BMI (P = .002) and smaller lesion diameters (P = .043) than those with detectable lesions.
• The model incorporating BMI, age, and lesion diameter achieved the highest area under the curve of 0.85 in predicting the detectability of cystic pancreatic lesions via TAUS.
• For lesions ≥ 1 cm, no significant differences were found between TAUS and EUS measurements, but significant differences in size determination were noted for lesions smaller than 1 cm. Moreover, the agreement between TAUS and EUS in the morphologic assessment of cystic pancreatic lesions was achieved in 65.6% of patients.

IN PRACTICE:

“We would like to emphasize that even if CPL [cystic pancreatic lesion] is first described via TAUS, at least one complementary EUS and or MRI examination are essential in order to sufficiently rule out relevant morphological irregularities and, especially in the case of corresponding clinical symptoms, coexistent carcinoma of the pancreas,” the authors of the study wrote.

SOURCE:

This study was led by Julian Seelig, Leipzig University Medical Center, Leipzig, Germany. It was published online on June 20, 2025, in Scientific Reports.

LIMITATIONS:

The study’s retrospective design and moderate sample size prevented stratification depending on cystic pancreatic lesion entities. The database was insufficient to incorporate MRI as a second reference method or to assess a larger group of patients with multiple or morphologically complex cysts. Moreover, the examiners for TAUS and EUS were not consistently blinded to the results from the other imaging method.

DISCLOSURES:

This study reported open access funding enabled and organised by Projekt DEAL, with no external funding. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.