Radiological Assessment of Cystic Pancreatic Neoplasms

Radiological Assessment of Cystic Pancreatic Neoplasms Cystic lesions of the pancreas are increasingly being detected due to the wide use of high-resolution CT and MRI. They encompass a broad spectrum of benign, premalignant, and malignant tumors which are primarily cystic or result from cystic necroses or hemorrhage of solid tumors. Among these lesions, intraductal papillary mucinous neoplasms, serous cystic neoplasms, mucinous cystic neoplasms, and solid pseudopapillary tumors represent the majority of the cases. With increasing experience, a refinement of our understanding regarding their morphology and their natural course has emerged. It is crucial to be familiar with the imaging features of these lesions in order to differentiate these tumors and to recognize malignant transformation. Because characterization of these tumors can sometimes be difficult due to overlapping imaging features, additional criteria such as clinical symptoms, localization, age, and gender have to be taken into account. CT is an excellent test for initial detection and characterization of such lesions. However, MRI is superior due to better characterization of the morphologic features of a cystic lesion and the precise assessment of duct communication. The management of cystic tumors of the pancreas has not yet been standardized and the correct evaluation of the disease in asymptomatic patients has not been fully defined.