simple ovarian cysts with no suspicious features on ultrasound, current follow-up guidelines are based on menopausal status and cyst size:
In women of reproductive age
≤3 cm
normal physiologic finding; at the discretion of the interpreting physician whether or not to describe them in the imaging report
do not need follow-up
>3 and ≤5 cm
should be described in the imaging report with a statement that they are almost certainly benign
do not need follow-up
>5 and ≤7 cm
should be described in the imaging report with a statement that they are almost certainly benign
increased risk of ovarian torsion 4
yearly follow-up with ultrasound recommended
>7 cm
may be difficult to assess completely with ultrasound and further imaging with MR or surgical evaluation should be considered
In post-menopausal women
≤1 cm
are clinically inconsequential; at the discretion of the interpreting physician whether or not to describe them in the imaging report
do not need follow-up
>1 and ≤7 cm
should be described in the imaging report with a statement that they are almost certainly benign
yearly follow-up, at least initially, with ultrasound recommended
some practices may opt to increase the lower size threshold for follow-up from 1 cm to as high as 3 cm
one may opt to continue follow-up annually or to decrease the frequency of follow-up once stability or decrease in size has been confirmed
cysts in the larger end of this range should still generally be followed on a regular basis
>7 cm
since these may be difficult to assess completely with ultrasound, further imaging with MRI or surgical evaluation should be considered