Fukuoka and AGA Criteria Have Superior Diagnostic Accuracy for Advanced Cystic Neoplasms than Sendai Criteria

Sighinolfi, Michael; Quan, Susan Y.; Lee, Yvonne; Ibaseta, Alvaro; Pham, Kimberly; Dua, Monica M.; Poultsides, George A.; Visser, Brendan C.; Norton, Jeffery A.; Park, Walter G.

doi:10.1007/s10620-017-4460-y

Cited by 23 publications

(11 citation statements)

References 19 publications

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“…Regarding the “ worrisome ” criteria, both guidelines had similar sensitivity. Overall, the FCG had a better performance than the SCG in predicting advanced neoplasia, which is consistent with the conclusions in most published articles . In addition, individual preference for the surgical resection of cysts is acceptable in our institution, which is mainly derived from abdominal discomfort.…”

Section: Discussionsupporting

confidence: 89%

Validation of Sendai and Fukuoka consensus guidelines in predicting malignancy in patients with preoperatively diagnosed mucinous pancreatic cystic neoplasms

Zhou

Rong

et al. 2017

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 89%

Validation of Sendai and Fukuoka consensus guidelines in predicting malignancy in patients with preoperatively diagnosed mucinous pancreatic cystic neoplasms

Zhou

Rong

et al. 2017

Journal of Surgical Oncology

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“…Changes in guidelines have improved identification of advanced neoplasia in IPMNs. Sighinolfi et al[ 13 ] retrospectively validated the 2006 ICG, 2012 ICG, and AGA criteria, where the 2012 ICG and AGA showed significantly improved specificity (58.2% and 62.4%, respectively) and diagnostic accuracy (67% and 68%, respectively) for advanced neoplasia compared to the 2006 ICG (specificity 32.7%, diagnostic accuracy 46%)[ 13 ]. Additionally, Kang et al[ 14 ] have demonstrated superior diagnostic performance of the 2017 ICG [area under the curve (AUC) 0.78] compared to 2012 ICG criteria (AUC 0.74) for the detection of malignancy in BD-or mixed-type IPMNs[ 14 ].…”

Section: How Do the Guidelines Perform?mentioning

confidence: 99%

Endosonographic diagnosis of advanced neoplasia in intraductal papillary mucinous neoplasms

Eiterman¹,

Lahooti²,

Krishna³

2020

WJG

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Pancreatic cancer has a high mortality rate with minimal proven interventions. Intraductal Papillary Mucinous Neoplasms (IPMNs) are known precursor lesions for pancreatic cancer. Identification of pancreatic cysts has improved from advances in abdominal imaging. Despite multiple revisions of the international consensus recommendations and various guidelines by other major societies, successful risk stratification of the malignant potential of mucinous pancreatic cysts remains challenging. Specifically, detection and accurate classification of advanced neoplasia (high-grade dysplasia and/or adenocarcinoma) in IPMNs is suboptimal with current diagnostic strategies. Development of interventional techniques utilizing endoscopic ultrasound include - through-the-needle microforceps biopsy, next-generation or whole genome molecular analysis of cyst fluid, and needle-based confocal laser endomicroscopy. These techniques suffer from a series of limitations in technical success, diagnostic yield, and clinical feasibility, but a combination approach may offer a solution that optimizes their cyst evaluation and risk stratification. Assessment and comparison of these techniques is restricted by lack of adequate surgical specimens for testing of diagnostic accuracy, resulting in a possible sample bias. Additional large-scale multicenter studies are needed to accumulate evidence for the utility and feasibility of their translation into clinical practice. Great strides have been made in pancreatic cyst evaluation, but further research is required to improve diagnostic accuracy and clinical management of IPMNs.

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“…The Sendai guidelines were revised in 2010 at the 13th Congress of the IAP in Fukuoka, Japan. This resulted in the publication of updated 2012 Fukuoka guidelines with revised criteria for imaging surveillance and surgical resection of branch duct IPMN 21 . Moreover, the Fukuoka guidelines incorporated the use of EUS‐FNA for cysts larger than or equal to 3 cm or smaller cyst's with pancreatitis or ‘worrisome features’ on CT imaging; this was an attempt to further delineate risk prior to making a decision for surgical resection 7 …”

Section: Guidelinesmentioning

confidence: 99%

Diagnostic approaches for pancreatic cystic lesions

Kanani

Isherwood

Chung

et al. 2020

ANZ Journal of Surgery

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Background: Cystic lesions of the pancreas (PCLs) may be inflammatory or proliferative and making an accurate and timely pre-operative diagnosis remains a significant clinical challenge. This is principally due to the heterogeneity of the pathological processes involved. PCLs constitute an entity with diverse histology and although infrequent, the possible potential for malignant transformation of these lesions and the opportunity for curative surgery mandates that our diagnostic approaches are up to date and evidence based. In addition, improved diagnostic accuracy is crucial to prevent unnecessary surgical procedures with the inevitable associated morbidity. Methods: This narrative review examines the current diagnostic benchmarks and identifies novel diagnostic techniques that warrant further consideration, a number of which are beginning to be included in routine clinical practice when these PCLs are being investigated. A computerized search was made of MEDLINE, EMBASE and PubMed using the search words 'diagnostic approaches to pancreatic cystic lesions'. All relevant articles in English language or with an English abstract were retrieved and additionally cross referenced. Conclusion: The increasing accuracy of available imaging techniques together with the wider availability of endoluminal ultrasound and the development of additional novel methods to assess PCLs presents an opportunity to significantly improve the pre-operative diagnosis rate. This is essential to classify the type of PCL and hence guide the management particularly with lesions where there is a likelihood of progression to more serious pathology. We have highlighted the need for a comprehensive and standardized algorithm for the diagnosis and management of PCLs.

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Fukuoka and AGA Criteria Have Superior Diagnostic Accuracy for Advanced Cystic Neoplasms than Sendai Criteria

Abstract: In a surgical series of patients with pancreatic cysts, the AGA and Fukuoka criteria had superior diagnostic accuracy for advanced neoplastic cysts compared to the original Sendai criteria.

Cited by 23 publications

References 19 publications

Validation of Sendai and Fukuoka consensus guidelines in predicting malignancy in patients with preoperatively diagnosed mucinous pancreatic cystic neoplasms

Validation of Sendai and Fukuoka consensus guidelines in predicting malignancy in patients with preoperatively diagnosed mucinous pancreatic cystic neoplasms

Endosonographic diagnosis of advanced neoplasia in intraductal papillary mucinous neoplasms

Diagnostic approaches for pancreatic cystic lesions

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