Volume 154, Issue 3, Pages (February 2018)

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Volume 154, Issue 3, Pages 576-584 (February 2018) Progression of Pancreatic Branch Duct Intraductal Papillary Mucinous Neoplasm Associates With Cyst Size Youngmin Han, Hongeun Lee, Jae Seung Kang, Jae Ri Kim, Hyeong Seok Kim, Jeong Min Lee, Kyoung-Bun Lee, Wooil Kwon, Sun- Whe Kim, Jin-Young Jang Gastroenterology Volume 154, Issue 3, Pages 576-584 (February 2018) DOI: 10.1053/j.gastro.2017.10.013 Copyright © 2018 AGA Institute Terms and Conditions

Figure 1 A total of 10,083 patients with suspicious IPMN were identified, and only 1369 eligible patients were identified for follow-up after a careful exclusion. IPMN, intraductal papillary mucinous neoplasm; PDAC, pancreatic ductal adenocarcinoma; MCN, mucinous cystic neoplasm; SPN, solid pseudopapillary neoplasm; NET, neuroendocrine tumor; RCC, renal cell carcinoma; USG, ultrasonography; MPD, main pancreatic duct. Gastroenterology 2018 154, 576-584DOI: (10.1053/j.gastro.2017.10.013) Copyright © 2018 AGA Institute Terms and Conditions

Figure 2 The median annual cyst growth rate was 0.8 mm, and rapidly growing cysts were observed according to the initial cyst size at detection. (A) Depiction of the changes in cyst size and (B) of cyst growth rate according to the initial cyst size. Gastroenterology 2018 154, 576-584DOI: (10.1053/j.gastro.2017.10.013) Copyright © 2018 AGA Institute Terms and Conditions

Figure 3 Changes in cystic features and worrisome features increase according to the initial cyst size. The number of patients with cysts >3 and those who were initially diagnosed with cysts >3 cm is not presented in this figure. Gastroenterology 2018 154, 576-584DOI: (10.1053/j.gastro.2017.10.013) Copyright © 2018 AGA Institute Terms and Conditions

Figure 4 A new surveillance protocol was devised for BD-IPMN patients without high-risk stigmata or worrisome features based on the initial cyst size and growth rate. The selection of diagnostic modality and follow-up period should be based on the cyst size at detection. Gastroenterology 2018 154, 576-584DOI: (10.1053/j.gastro.2017.10.013) Copyright © 2018 AGA Institute Terms and Conditions