88 Comparison of Pancreatic Cyst Surveillance with USS and MRI: Retrospective Two Centre Analysis

Abstract Aim Pancreatic cyst (PC) is a common incidental finding which requires MRI surveillance. This is costly and affects waiting times of other conditions which may only be surveyed with MRI. We aimed to determine if USS can safely replace MRI in surveillance of PC. Method We compared the USS and MRI surveillance of PC between two university hospitals situated 25 miles apart. We performed a retrospective search of radiology reporting system on both sites over a six-year period, collected detailed data of the first two follow up years and checked for progression to cancer over a minimum of five-year period. Results 220 patients were surveyed with USS and 228 with MRI. The patient cohorts were age and sex matched. The MRI group had larger (median 14mm vs 11mm, p < 0.001) and greater number of complex PC (17% vs 7.5%, p = 0.006). Three cancers were detected in each cohort. There was no statistically significant difference in cancer detection rates between groups. The total of 1060 USS and 800 MRI scans were performed. The total cost of USS surveillance was £61,480, while MRI surveillance cost £150,400. The estimated average surveillance cost per patient was £279.45 for USS and £659.65 for MRI. This represents an estimated cost saving of £380.19 per patient, and a total saving of £88,920 in this cohort if USS had been used instead of MRI. Conclusions USS is a safe and effective modality for surveillance of PC. Switch from MRI to USS can significantly reduce the cost of PC surveillance.