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Fukuoka IPMN

Fukuoka international consensus imaging features for intraductal papillary mucinous neoplasm

Stratifies pancreatic IPMN by worrisome features and high-risk stigmata on cross-sectional imaging to guide surveillance versus resection.

vigenteInternational Association of Pancreatology2017MRI, CT
Fonte primária3 categorias
no-risk-featuresNo worrisome features or high-risk stigmataworrisome-featuresWorrisome featureshigh-risk-stigmataHigh-risk stigmata

Aplicar o Fukuoka IPMN a um achado

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Categorias

Reescritas a partir da fonte e citadas
no-risk-features
1 de 3

No worrisome features or high-risk stigmata

Neither high-risk stigmata nor worrisome features present on imaging: a branch-duct IPMN below the worrisome-feature thresholds (cyst <3 cm, no enhancing mural nodule, main pancreatic duct <5 mm, no concerning secondary features).

CondutaImaging surveillance rather than resection; the source describes risk-stratified follow-up of cysts without worrisome features or high-risk stigmata.
RiscoLowest malignancy risk category among IPMN; managed by surveillance.
verificadoRevisions of international consensus Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreasPMC8713311, Table 2 (revised Fukuoka 2017): absence of the listed worrisome features and high-risk stigmata.
worrisome-features
2 de 3

Worrisome features

Worrisome features: cyst size >=3 cm; enhancing mural nodule <5 mm; thickened/enhancing cyst walls; main pancreatic duct 5-9 mm; abrupt change in main-duct caliber with distal pancreatic atrophy; lymphadenopathy; elevated serum CA 19-9; acute pancreatitis attributable to the IPMN; and cyst growth rate >5 mm over 2 years.

CondutaFurther assessment, typically endoscopic ultrasound (EUS), rather than immediate resection; the presence of worrisome features prompts closer evaluation.
RiscoIntermediate malignancy risk warranting additional workup.
verificadoRevisions of international consensus Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreasPMC8713311, Table 2: worrisome features 'Cyst size >= 3 cm; Acute pancreatitis (due to IPMN); Enhancing mural nodule >= 5 mm; Thickened and enhancing cyst wall; MPD dilation 5-9 mm; Abrupt change of MPD caliber with distal pancreatic atrophy; Presence of lymphadenopathy; Elevated serum CA 19-9; Cyst growth rate > 5 mm/2 yr'.
high-risk-stigmata
3 de 3

High-risk stigmata

High-risk stigmata: obstructive jaundice in a patient with a cystic lesion of the pancreatic head; enhancing mural nodule >=5 mm; main pancreatic duct >=10 mm; (and high-grade dysplasia or cancer on cytology).

CondutaSurgical resection is recommended for surgically fit patients with any high-risk stigmata.
RiscoHighest malignancy risk category; resection advised.
verificadoRevisions of international consensus Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreasPMC8713311, Table 2: high-risk stigmata 'Jaundice; Enhancing mural nodule >= 5 mm; MPD >= 10 mm' (plus 'HGD or cancer on cytology').
Lógica de decisão estruturada
{
  "categories": [
    "no-risk-features",
    "worrisome-features",
    "high-risk-stigmata"
  ]
}

Referência, não é dispositivo médico. Confira a publicação primária vigente. O radiologista que assina o laudo continua autor e responsável.