{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:38:47Z","timestamp":1792820327832,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Accurate preoperative measurement of pancreatic cystic lesions is critical for surgical decision-making, particularly around the 3\u00a0cm threshold frequently cited in resection guidelines. However, imaging modalities may provide discrepant size estimates, potentially altering management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients from a single endoscopist practice (November 2011-November 2024) who underwent EUS-FNA for pancreatic cystic lesions with available MRI and\/or CT imaging results. For each modality, the largest recorded dimension was extracted. One-way ANOVA was performed to assess mean size differences, and concordance across the 3\u00a0cm surgical threshold was calculated with Cohen\u2019s \u03ba.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 190 patients with 246 patient encounters were included. Mean cyst size was 2.93 \u00b1 1.32\u00a0cm on MRI (n = 147), 2.95 \u00b1 1.53\u00a0cm on EUS (n = 246), and 3.20 \u00b1 1.73\u00a0cm on CT (n = 159). The differences were not statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .194). Across modalities, the mean absolute difference in size ranged from 0.7 to 0.9\u00a0cm, with outliers exceeding 2\u00a0cm. Concordance at the 3\u00a0cm cutoff was common; there was good agreement between EUS and MRI (\u03ba = 0.643;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and moderate agreement between EUS and CT (\u03ba = 0.472;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Substantial variability exists in preoperative size assessment of pancreatic cystic lesions, with 7.5-20% of cysts misclassified around the 3\u00a0cm cutoff. Given that cyst size is a key determinant of surgical intervention, reliance on a single modality may introduce bias into clinical decision-making. Multimodality assessment reduces discordance and may improve risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261443347","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:25:51Z","timestamp":1776263151000},"page":"2820-2824","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-Modality Differences In Pancreatic Cyst Size Measurements May Affect Surgical Decision-Making"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8397-9186","authenticated-orcid":false,"given":"Tamir E.","family":"Bresler","sequence":"first","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Lada","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivam","family":"Pandya","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austen","family":"Mauch","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zin","family":"Htway","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumar","family":"Desai","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2309041"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.02.010"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.02.013"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.11.046"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001666"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.7334\/psicothema2016.383"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.02.041"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000489233"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v13.i12.1880"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2023.12.009"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.2232"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.36827"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-015-0588-4"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-017-5268-z"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.10.013"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.08.003"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000558"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2022.06.008"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2023.03.003"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.09.011"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261443347","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261443347","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261443347","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:10:29Z","timestamp":1792818629000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261443347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/00031348261443347"],"URL":"https:\/\/doi.org\/10.1177\/00031348261443347","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]}}}