We recommend a combination of MRI with MRCP, serum labs (amylase, lipase, CEA, CA19-9, ALT, HbA1c), and the consideration of baseline EUS (with FNA if cyst >1 cm and CLE if cyst > 2 cm) in patients with an indeterminate cyst type, younger age (age < 75), positive family history, or germline mutation to better define the cyst subtype which can then ensure adequate surveillance. This evidence concerns the gene GPT and cyst.