On US: SRU Criteria

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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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