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Variation in Radiologists' Follow-Up Imaging Recommendations for Small Cystic Pancreatic Lesions.

Neena Kapoor1, Ronilda Lacson2, Mahsa Eskian3

  • 1Director of Diversity, Equity, and Inclusion, Quality and Patient Safety Officer, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

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|June 26, 2021
PubMed
Summary

Radiologist variation impacts follow-up imaging recommendations for small focal cystic pancreatic lesions (FCPLs). Factors like age and lesion characteristics influence decisions, but interradiologist differences persist.

Keywords:
Follow-up imagingnatural language processingpancreatic cyst

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Area of Science:

  • Radiology
  • Gastroenterology
  • Medical Imaging

Background:

  • Small focal cystic pancreatic lesions (FCPLs) are common incidental findings on abdominal imaging.
  • Standardized follow-up recommendations for FCPLs are crucial for patient management and resource allocation.

Purpose of the Study:

  • To determine the incidence of follow-up recommendations for small FCPLs.
  • To identify patient and imaging factors associated with these recommendations.
  • To quantify interradiologist variation in follow-up decisions.

Main Methods:

  • Retrospective analysis of 146,709 abdominal CT and MRI reports.
  • Natural language processing identified 4,345 reports with FCPLs; 2,872 reports with <1.5 cm cysts were manually reviewed.
  • Multivariable analysis and random-effects modeling assessed factors and radiologist variation.

Main Results:

  • Only 24.7% of small FCPLs (<1.5 cm) had follow-up recommendations.
  • Older age, main duct dilatation, and septation were associated with higher recommendation rates.
  • No significant association found between radiologist experience, trainee presence, or gender and recommendation rates.

Conclusions:

  • Significant interradiologist variation exists in follow-up recommendations for FCPLs.
  • This variability contributes to inconsistent patient management for these common incidental findings.