PURPOSE: This study aimed to evaluate the utility of targeted abdominal ultrasound (TAUS) for follow-up of low-risk pancreatic cystic lesions (PCLs), assessing diagnostic performance, agreement with advanced imaging, patient acceptance, clinical usefulness, and contribution of structured reporting. METHODS: This prospective study included 120 patients with low-risk PCLs previously characterized by magnetic resonance cholangiopancreatography or endoscopic ultrasound. TAUS was performed using a wideband convex matrix probe (1.8-6.2 MHz) and a structured protocol documenting lesion location, size, morphology (septa, mural nodules), and relation to the main pancreatic duct. Contrast-enhanced ultrasound (CEUS) was used in selected cases. Outcomes included agreement with reference imaging (intraclass correlation coefficient [ICC]), patient preference, and perceived usefulness. RESULTS: TAUS enabled complete pancreatic visualization in 80.0% of patients and overall detection rate in 88.3%. Detection varied by location (P=0.028), highest in the body (94.5%) and lowest in the tail (68.0%). Agreement for maximal cyst diameter was excellent (ICC, 0.98; 95% confidence interval, 0.971 to 0.986), with 90.8% of measurements within ±20% of the reference modality. When B-mode was suboptimal, CEUS was used in 2.5% of cases and improved delineation of architecture (mural nodules, septations). Limitations included low detection of multifocal disease (11.1%) and restricted assessment of ductal communication (46.6%). TAUS was clinically useful in 78.0% and preferred by patients when characterization was adequate (88.3%). CONCLUSION: TAUS is a promising noninvasive imaging tool for monitoring low-risk PCLs in favorable acoustic windows, showing high diagnostic accuracy, excellent agreement with advanced imaging, and strong patient acceptance. Its diagnostic performance is limited in multifocal, complex, or tail-located lesions.
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Marín‐Serrano et al. (2025) studied this question.