ArticleAnnals of surgical oncology2026
Quantitative CT-Derived Imaging Features Improve Preoperative Risk Stratification of Intraductal Papillary Mucinous Neoplasms.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAccurate preoperative identification of high-grade dysplasia (HGD) or malignancy in intraductal papillary mucinous neoplasms (IPMNs) remains challenging using conventional guideline-based imaging criteria. Quantitative computed tomography (CT)-based features may detect subtle structural changes preceding overt radiologic findings. This study aimed to evaluate whether the pancreatic index (PI) and additional three-dimensional CT-derived quantitative features improve prediction of HGD or malignancy in IPMNs.
methodsThis single-center retrospective study included patients who underwent surgical resection for pathologically confirmed IPMNs between January 2001 and August 2024 and had available preoperative pancreas-protocol CT. Three-dimensional quantitative parameters were analyzed.
resultsAmong 333 patients, 204 had low-grade dysplasia (LGD), 56 had HGD, and 73 had malignancy. PI decreased with increasing histologic grade (75.6 ± 10.2% in LGD, 74.5 ± 12.0% in HGD, 70.5 ± 12.6% in malignancy; p = 0.003). Pancreatic Hounsfield unit standard deviation (HU-SD) was significantly higher in HGD and malignancy than in LGD (25.6 ± 5.9, 29.0 ± 8.7, and 29.6 ± 6.2, respectively; p < 0.001). A combined model integrating guideline-based criteria with PI, CI, cystic HU-SD, pancreatic HU-SD, and pancreatic duct volume demonstrated better discrimination than the guideline-only model (area under the curve 0.800 vs. 0.760; p = 0.007).
conclusionsQuantitative CT-derived imaging features provide incremental value for predicting HGD and malignancy when integrated with conventional guideline-based criteria. These noninvasive imaging biomarkers may enhance risk stratification and provide additional information to support clinical decision-making when integrated with conventional criteria. Further external validation is required to establish their clinical utility in routine practice.
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