On US: SRU Criteria

Reproductive Age	Cyst Morphology	Postmenopausal
<3cm, Optional to mention. No follow up. 3-5cm, Mention in report. No follow up 5-6cm, Yearly followup >7cm, Surgical referral	Simple Cysts	1-7cm, yearly followup >7cm, surgical referral
<5cm, No follow up >5cm 6-12 week follow up to ensure resolution	Hemorrhagic Cysts	Early post-menopausal, 6-12 week follow up to ensure resolution Late post-menopausal, consider surgical referral
Initial follow up at 6-12 weeks Yearly follow up unless removed	Endometrioma	Initial follow up at 6-12 weeks Yearly follow up unless removed
Follow yearly if not removed	Dermoid	Follow yearly if not removed
Indeterminate but likely benign cysts
Follow up at 6-12 weeks. If not resolved continue to follow with US or MRI. If benign lesion not confirmed by additional imaging then surgical referral.	Likely Hemorrhagic cyst, endometrioma, or dermoid (But not diagnostic)	Follow up at 6-12 weeks. If not resolved continue to follow with US or MRI. If benign lesion not confirmed by additional imaging then surgical referral.
Likely a benign neoplasm. Consider surgical referral.	Multiple thin septations	Likely a benign neoplasm. Consider surgical referral.
Likely a benign neoplasm. Consider surgical referral.	Mural nodule without flow	Likely a benign neoplasm. Consider surgical referral.
Cysts with worrisome characteristics
Surgical referral.	Thick (>3mm), irregular septations. Nodule with flow.	Surgical referral.

1. Management of Asymptomatic Ovarian and Other Adnexal Cysts Imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statementby Deborah Levine et al. September 2010 Radiology, 256, 943-954.

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