Very small cysts can be followed to detect an increase in size that may indicate cancer or an increased risk of developing cancer. Not all cysts need to have endoscopic ultrasound or be aspirated; some may have characteristics so suggestive of malignancy that surgery is recommended without endoscopic ultrasound. Others may have characteristics so suggestive of a non-cancerous cyst that no endoscopic ultrasound needs to be done although imaging studies (ultrasound, CT, MRI) may be repeated periodically. There are not yet standard recommendations for managing pancreatic cysts. Different medical centers have adopted different approaches to diagnosis and treatment. Management decisions must be individualized for each patient after discussions with a doctor familiar with the patient's health status. The following are examples of how a doctor might manage pancreatic cysts.