Global Prevalence of Pancreatic Cystic Lesions in the General Population on Magnetic Resonance Imaging: A Systematic Review and Meta-analysis

• Published in: Clinical gastroenterology and hepatology Vol. 22; no. 9; pp. 1798 - 1809.e6
• Main Authors: Vilela, Ana, Quingalahua, Elit, Vargas, Alejandra, Hawa, Fadi, Shannon, Carol, Carpenter, Eileen S., Shi, Jiaqi, Krishna, Somashekar G., Lee, Un-Jung, Chalhoub, Jean M., Machicado, Jorge D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2024
• Subjects: Burden; Epidemiology; Female; Gastroenterology and Hepatology; Global Health; Humans; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging - statistics & numerical data; Male; Pancreas - diagnostic imaging; Pancreas - pathology; Pancreas Cyst; Pancreatic Cyst - diagnostic imaging; Pancreatic Cyst - epidemiology; Prevalence; Radiology; CT; EUS; Prevalence; MRI; Pancreas Cyst; CI; MRCP; Radiology; PCL; IPMN; Burden; Epidemiology; computed tomography; magnetic resonance imaging; pancreatic cystic lesion; intraductal papillary mucinous neoplasm; endoscopic ultrasound; confidence interval; magnetic resonance cholangiopancreatography
• ISSN: 1542-3565; 1542-7714; 1542-7714
• DOI: 10.1016/j.cgh.2024.02.018

Understanding the burden of pancreatic cystic lesions (PCLs) in the general population is important for clinicians and policymakers. In this systematic review, we sought to estimate the global prevalence of PCLs using magnetic resonance imaging (MRI) and to investigate factors that contribute to its variation. We searched MEDLINE, EMBASE, and Cochrane Central, from database inception through February 2023. We included full-text articles that reported the prevalence of PCLs using MRI in the general population. A proportional meta-analysis was performed, and the prevalence of PCLs was pooled using a random-effects model. Fifteen studies with 65,607 subjects were identified. The pooled prevalence of PCLs was 16% (95% confidence interval [CI], 13%–18%; I2 = 99%), most of which were under 10 mm. Age-specific prevalence of PCLs increased from 9% (95% CI, 7%–12%) at 50 to 59 years, to 18% (95% CI, 14%–22%) at 60 to 69 years, 26% (95% CI, 20%–33%) at 70 to 79 years, and 38% at 80 years and above (95% CI, 25%–52%). There was no difference in prevalence between sexes. Subgroup analysis showed higher PCL prevalence when imaging findings were confirmed by independent radiologist(s) (25%; 95% CI, 16%–33%) than when chart review alone was used (5%; 95% CI, 4%–7%; P < .01). There was no independent association of PCL prevalence with geographic location (Europe, North America, or Asia), MRI indication (screening vs evaluation of non-pancreatic pathology), enrollment period, sample size, magnet strength (1.5 vs 3 tesla), and MRI sequence (magnetic resonance cholangiopancreatography vs no magnetic resonance cholangiopancreatography). In this systematic review, the global prevalence of PCLs using a highly sensitive noninvasive imaging modality ranged between 13% and 18%.