Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Korean J Radiol. 2024 Dec;25(12):1047-1060. doi: 10.3348/kjr.2024.0626. Epub 2024 Nov 8.
To survey experts' opinions in abdominal radiology (radiologists) and pancreas-specialized gastroenterology (pancreatologists) in South Korea regarding diagnosing and managing pancreatic cystic neoplasms (PCNs).
Between August 25, 2023, and October 5, 2023, an online survey was conducted among members of the Korean Society of Abdominal Radiology and the Korean Pancreatobiliary Association via email invitation.
The responses from 100 radiologists and 41 pancreatologists were analyzed. Of the respondents, 55.3% (78/141) reported seeing more than 50 patients or reading more than 50 exams related to PCN each month. The most common and preferred diagnostic modality for PCN was contrast-enhanced computed tomography (CECT), favored by 87.8% (36/41) of pancreatologists. When discrepancies arose between CECT or magnetic resonance imaging (MRI) and endoscopic ultrasound, 31.2% (44/141) of the respondents opted for multidisciplinary team discussion, whereas 29.1% (41/141) chose short-term follow-up using CECT or MRI. A total of 88.7% (125/141) of the respondents adhered to the 2017 International Association of Pancreatology (IAP) guidelines in their practice. Among the radiologists, 51.0% (51/100) endorsed a cut-off value of 5 mm for enhancing mural nodules, and 22.0% (22/100) supported a 5 mm/2 yr growth rate in the IAP guidelines v.2017. Additionally, 73.0% (73/100) of radiologists favored discontinuing surveillance, whereas 41.5% (17/41) of pancreatologists disagreed with stopping surveillance.
The survey underscores the clinical burden PCN poses and identifies CECT as the foremost diagnostic tool. Variability was noted in the terminology, differential diagnosis, approaches for resolving discrepancies between imaging examinations, and opinions on surveillance discontinuation among the respondents as a whole, as well as between radiologists and pancreatologists. Although the 2017 IAP guidelines are primarily followed, there remains a level of dissatisfaction with risk stratification among radiologists. This highlights the need for more standardized diagnostic algorithms and improved consensus among specialists to address these challenges.
调查韩国腹部放射科（放射科医生）和胰腺专科胃肠病学（胰腺病学家）专家在诊断和管理胰腺囊性肿瘤（PCN）方面的意见。
2023 年 8 月 25 日至 10 月 5 日期间，通过电子邮件邀请，对韩国腹部放射学会和韩国胰腺胆道协会的成员进行了在线调查。
对 100 名放射科医生和 41 名胰腺病学家的回复进行了分析。在应答者中，55.3%（78/141）报告称，每月看 50 名以上患者或阅读 50 份以上与 PCN 相关的检查。PCN 的最常见和首选诊断方式是对比增强计算机断层扫描（CECT），87.8%（36/41）的胰腺病学家首选该方式。当 CECT 或磁共振成像（MRI）与内镜超声检查结果不一致时，31.2%（44/141）的应答者选择多学科团队讨论，29.1%（41/141）选择使用 CECT 或 MRI 进行短期随访。88.7%（125/141）的应答者在实践中遵循 2017 年国际胰腺病学会（IAP）指南。在放射科医生中，51.0%（51/100）支持增强壁结节的 5mm 截断值，22.0%（22/100）支持 IAP 指南 2017 年版中 5mm/2 年的生长速度。此外，73.0%（73/100）的放射科医生赞成停止监测，而 41.5%（17/41）的胰腺病学家不同意停止监测。
该调查强调了 PCN 带来的临床负担，并确定 CECT 是主要的诊断工具。在整个应答者群体中，以及在放射科医生和胰腺病学家之间，在术语、鉴别诊断、解决影像学检查结果不一致的方法以及对监测停止的意见方面，存在差异。尽管主要遵循 2017 年 IAP 指南，但放射科医生对风险分层仍存在不满。这突出表明需要更标准化的诊断算法，并在专家之间达成更好的共识，以应对这些挑战。
