Abdominal Radiology最新文献

{"title":"Growth without dilution: impact, integrity, and the next phase of abdominal radiology","authors":"Neeraj Lalwani","doi":"10.1007/s00261-026-05669-w","DOIUrl":"10.1007/s00261-026-05669-w","url":null,"abstract":"","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 8","pages":"3725 - 3726"},"PeriodicalIF":2.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cinematic rendering in pancreatic imaging: CT features and malignancy indicators of mucinous cystic neoplasms","authors":"Zahra F. Rahmatullah,&nbsp;Sebastian Krueger,&nbsp;Connor W. Smith,&nbsp;Philippe Soyer,&nbsp;Linda C. Chu,&nbsp;Elliot K. Fishman","doi":"10.1007/s00261-026-05568-0","DOIUrl":"10.1007/s00261-026-05568-0","url":null,"abstract":"<div><p>Pancreatic mucinous cystic neoplasms (MCNs) are benign lesions with potential for malignant transformation. Accurate differentiation from other pancreatic cystic lesions remains challenging through conventional imaging modalities. Cinematic rendering (CR) is an advanced 3D computed tomography (CT) post-processing technique that generates photorealistic images with enhanced texture mapping and improved anatomical detail. It has not been previously discussed as a diagnostic tool for MCNs. Through added depth perception and tissue differentiation, CR complements conventional CT by enhancing visualization of morphology, internal components such as septations, calcification patterns, vascular involvement, and features suspicious of malignancy. It also helps with assessment of resectability and surgical planning by clearly highlighting vascular involvement. It is of note that further research is needed to quantify its added diagnostic value and optimize its role in clinical decisions in the evaluation of MCNs.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5499 - 5506"},"PeriodicalIF":2.3,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive performance of CT-based artificial intelligence for predicting variceal bleeding in portal hypertension: a systematic review and meta-analysis","authors":"Chao Zhu,&nbsp;Qi Liu,&nbsp;Wenhui Tao,&nbsp;Bolun Fu,&nbsp;Fengyong Yang,&nbsp;Kun Yang,&nbsp;Yuzhen Bao,&nbsp;Bin Cao,&nbsp;Lili Liu,&nbsp;Jiafu Ma,&nbsp;Fan Qi,&nbsp;Shuai Han,&nbsp;Xin Lian","doi":"10.1007/s00261-026-05564-4","DOIUrl":"10.1007/s00261-026-05564-4","url":null,"abstract":"<div><h3>Objectives</h3><p>To systematically evaluate the predictive accuracy of computed tomography (CT)-based artificial intelligence (AI) for predicting variceal bleeding (VB) in patients with portal hypertension, and to assess their potential utility as an opportunistic screening tool alongside Baveno VII criteria.</p><h3>Methods</h3><p>We searched PubMed, Embase, Web of Science, and Cochrane until December 16, 2025, for studies applying radiomics or machine learning algorithms to abdominal CT images for VB prediction. Quality was assessed using PROBAST + AI. A bivariate random-effects model was employed to calculate pooled sensitivity, specificity, and the area under the curve (AUC).</p><h3>Results</h3><p>Ten studies encompassing 2,470 patients were included. CT-based AI models demonstrated promising predictive performance with a pooled sensitivity of 0.81 (95% Confidence Interval [CI]: 0.73–0.87), specificity of 0.85 (95% CI: 0.75–0.91), and an AUC of 0.88 (95% CI: 0.85–0.91). Unimodal image-only models achieved higher sensitivity than multimodal models (0.84 vs. 0.78). While a Vision Transformer architecture achieved the highest accuracy (AUC 0.98), it was limited to internal validation. Fagan’s nomogram indicated a negative likelihood ratio of 0.23, reducing an assumed post-test probability of bleeding from 20% to 5%.</p><h3>Conclusion</h3><p>CT-based AI models exhibit high predictive efficacy and offer a promising non-invasive “gatekeeper” strategy for risk stratification. By leveraging routine imaging, these models may reduce unnecessary endoscopies for low-risk patients. However, given the reliance on internal validation and HBV-predominant cohorts, results should be interpreted as valuable adjunctive evidence rather than a standalone replacement. Large-scale, international multi-center validation is required to confirm generalizability before clinical implementation.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5484 - 5498"},"PeriodicalIF":2.3,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BMI-dependent discordance between transient and MR elastography: risk of fibrosis overestimation in severe obesity","authors":"Akash Roy,&nbsp;Surabhi Jajodia,&nbsp;Shardhya Chakraborty,&nbsp;Shruti Keyal,&nbsp;Awanish Tewari,&nbsp;Nikhil Sonthalia,&nbsp;Sarthak Chakrabarti,&nbsp;Sourish Roy,&nbsp;Rajat Khandelwal,&nbsp;Uday Chand Ghoshal,&nbsp;Mahesh Kumar Goenka","doi":"10.1007/s00261-026-05565-3","DOIUrl":"10.1007/s00261-026-05565-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Elastography is central to fibrosis risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD). While vibration-controlled transient elastography (VCTE) is most widely used, magnetic resonance elastography (MRE) is more accurate. A discordance between them has been reported, and body mass index (BMI) has been proposed as a determinant. We investigated the impact of BMI on VCTE–MRE discordance in a real-world cohort.</p><h3>Methods</h3><p>This retrospective study included 268 adults with MASLD who underwent VCTE and MRE within 30 days. The primary endpoint was high-grade cross-threshold discordance, defined as VCTE ≥ F3 with MRE &lt; F2 or MRE ≥ F3 with VCTE &lt; F2. Secondary endpoints included discordance at ≥F2,≥F3, and ≥ 2-stage disagreement. Predictors of high-grade discordance were evaluated using logistic regression adjusted for age, sex, and diabetes. BMI-stratified calibration models were developed to harmonize TE values into MRE-equivalent scores.</p><h3>Results</h3><p>VCTE and MRE showed moderate correlation (Spearman ρ = 0.54; log-Pearson <i>r</i> = 0.70) and moderate staged agreement (κ = 0.50). High-grade discordance occurred in 19.0% overall and increased sharply with BMI: 7.7% (&lt; 25), 10.3% (25–29.9), 21.4% (30–34.9), and 64.7% (≥ 35). Discordance was predominantly TE-high/MRE-low. Multivariable analysis showed that every 5 kg/m² increase in BMI nearly tripled the odds of high-grade discordance (OR 2.70; 95% CI 1.93–3.93). Calibration modelling revealed that advanced VCTE values in patients with BMI ≥ 35 corresponded to MRE values well below the threshold for advanced fibrosis.</p><h3>Conclusion</h3><p>In MASLD, VCTE–MRE discordance is strongly BMI-dependent and clinically consequential in severe obesity, supporting BMI-aware fibrosis triage and modality harmonization.</p><h3>Graphical abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5911 - 5917"},"PeriodicalIF":2.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic cystic lesions revisited: morphologic patterns and diagnostic pitfalls in daily practice","authors":"Akio Tamura,&nbsp;Eisuke Mukaida,&nbsp;Kumpei Kirita,&nbsp;Jun Obara,&nbsp;Kazuyuki Ishida,&nbsp;Masao Nishiya,&nbsp;Naoki Yanagawa,&nbsp;Kunihiro Yoshioka","doi":"10.1007/s00261-026-05552-8","DOIUrl":"10.1007/s00261-026-05552-8","url":null,"abstract":"<div><p>The increasing use of cross-sectional imaging has led to more frequent incidental detection of pancreatic cystic lesions, presenting diagnostic challenges for radiologists. These lesions encompass a heterogeneous spectrum ranging from benign cysts to premalignant and malignant neoplasms, often with overlapping imaging features. Accurate imaging-based characterization is therefore essential for risk assessment and clinical management. This review presents a morphology-based approach to pancreatic cystic lesions, emphasizing morphologic imaging patterns as a practical framework for structured interpretation. Key features—including ductal communication, internal architecture, and the presence of mural nodules or solid components—are discussed in relation to their pathologic basis and clinical implications. Representative examples illustrate the characteristic appearances of common cystic neoplasms, including serous cystic neoplasm, mucinous cystic neoplasm, and intraductal papillary mucinous neoplasm, along with their variants. Particular attention is given to diagnostic pitfalls and mimickers, such as cystic degeneration of solid tumors including neuroendocrine tumors, solid pseudopapillary neoplasms, and pancreatic ductal adenocarcinoma, which may closely resemble true cystic lesions but require fundamentally different management. Through illustrative cases, this review highlights the importance of integrating morphologic pattern analysis with enhancement characteristics, ductal anatomy, and ancillary imaging findings. Recognition of these patterns and potential pitfalls is essential for accurate interpretation and clinically meaningful guidance.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5469 - 5483"},"PeriodicalIF":2.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRCP-derived radiomics features associated with biliary dilation: a multi-step feature reduction, multivariable regression, and diagnostic classification study","authors":"Alok Verma,&nbsp;Naresh Kumar Mangalhara,&nbsp;Shashank Sharma,&nbsp;Naman Gupta,&nbsp;Ayush Khandelwal,&nbsp;Meenu Bagarhatta","doi":"10.1007/s00261-026-05560-8","DOIUrl":"10.1007/s00261-026-05560-8","url":null,"abstract":"<div><h3>Purpose</h3><p>To identify MRCP-derived radiomics features associated with image-defined biliary dilation, evaluate their independence from demographic confounders, and assess diagnostic classification performance, including in borderline-caliber cases.</p><h3>Methods</h3><p>In this retrospective cross-sectional study, 135 patients (dilated: <i>n</i> = 60; non-dilated: <i>n</i> = 75) who underwent clinically indicated MRCP (September 2025-January 2026) were included. Two blinded radiologists independently classified biliary dilation (Cohen’s kappa = 0.87). Three-dimensional CBD segmentation was performed in 3D Slicer (v5.10.0), with feature extraction using PyRadiomics in compliance with IBSI guidelines. Feature reduction applied sequential reproducibility filtering (ICC (2,1) ≥ 0.80), low-variance filtering, Spearman correlation filtering (|r| &gt; 0.90), Benjamini–Hochberg FDR correction (q &lt; 0.05), and Cliff’s delta thresholding (|δ| &gt; 0.5). Multivariable linear regression adjusted for age, sex, and post-cholecystectomy status. Shape features were excluded from classification analyses to avoid incorporation bias. Three classifiers (Random Forest, Logistic Regression, and Naïve Bayes) were trained on the seven Bonferroni-confirmed texture features using five-fold stratified cross-validation. A post hoc exploratory analysis in borderline CBD caliber (6–10 mm; <i>n</i> = 45) used a two-feature model with internal tenfold cross-validation.</p><h3>Results</h3><p>Twelve features met selection thresholds: four shape and eight texture features. The strongest discriminators were RunLengthNonUniformity (δ = 0.870; q = 1.09 × 10⁻¹⁶) and GrayLevelNonUniformity (δ = 0.861; q = 1.43 × 10⁻¹⁶). Multivariable regression demonstrated that 11 of 12 features were significant independent correlates of image-defined biliary dilation after Bonferroni correction (all <i>p</i> &lt; 0.001). In the full cohort (<i>n</i> = 135; seven texture features), Random Forest achieved AUC = 0.963, accuracy = 92.1%, sensitivity = 94.3%, and specificity = 89.5%. In the exploratory borderline subgroup (<i>n</i> = 45; 6–10 mm; two-feature model), Random Forest achieved AUC = 0.832, suggesting potential discriminatory utility in equivocal cases.</p><h3>Conclusion</h3><p>MRCP-derived radiomic features are associated with image-defined CBD dilation and show exploratory internal cross-validated diagnostic performance, including in borderline cases, using standard clinical acquisitions. Prospective multicenter validation with independent clinical reference standards is required before clinical implementation.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5887 - 5901"},"PeriodicalIF":2.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRCP surveillance of low-risk branch-duct IPMNs: longitudinal size changes and clinical outcomes in a real-world cohort","authors":"Nesrin Gunduz,&nbsp;Huseyin Ertugrul Ozay,&nbsp;Muhammed Furkan Tapan,&nbsp;Fatih Buyuker,&nbsp;Orhan Alimoglu","doi":"10.1007/s00261-026-05561-7","DOIUrl":"10.1007/s00261-026-05561-7","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate cyst growth patterns, interval radiological changes, and clinical outcomes in patients with low-risk branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) without baseline worrisome features (WF) or high-risk stigmata (HRS), and to assess whether current surveillance strategies might be individualized in this subgroup.</p><h3>Methods</h3><p>In this retrospective single-center study, MRCP examinations performed between 2015 and 2025 were reviewed. Among 601 patients with BD-IPMN, 76 patients without baseline WF/HRS and with at least two MRCP examinations were included. The primary study endpoint was a composite of clinically actionable progression (new WF/HRS, including main pancreatic duct (MPD) dilatation 5–9 mm, or surgical intervention) or study-defined meaningful cyst growth (&gt; 2 mm/year or ≥ 20%/year). Interobserver agreement was assessed using intraclass correlation coefficient (ICC). Descriptive analyses, sensitivity analyses, and exploratory association analyses were performed.</p><h3>Results</h3><p>The cohort had a mean age of 65.6 ± 10.7 years, with 58% female patients. The median follow-up duration was 39.5 months (IQR 27.8–72.0). Although follow-up extended longer in a subset of patients, the cohort’s median observation time was approximately 3.3 years., with a median of 3 MRCPs per patient. Median cyst size increased minimally from 10.0 mm to 11.0 mm, with a median annual growth of 0.11 mm/year. The composite endpoint occurred in 9 patients (11.8%), comprising 5 clinically actionable events (3 BD-IPMN-related WF and 2 MPD dilatation cases classified as WF) and 4 cases of meaningful cyst growth without other WF/HRS. No patient developed HRS or underwent surgical intervention. No patient developed remote PDAC during follow-up. Interobserver agreement was excellent (ICC ≥ 0.93).</p><h3>Conclusion</h3><p>Low-risk BD-IPMNs demonstrated minimal growth and infrequent clinically actionable progression during MRCP surveillance. These findings are consistent with an indolent course, particularly in patients with small cysts, but should be interpreted in the context of limited event counts, non-standardized contrast use, selection bias, and a median follow-up of approximately 3.3 years. Larger multicenter studies with standardized imaging and longer follow-up are needed before specific surveillance de-escalation strategies can be recommended.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5902 - 5910"},"PeriodicalIF":2.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05561-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative prediction of lymph node metastasis in endometrial carcinoma based on MRI radiomic, clinical, and sonographic features: a clinical dual-center study","authors":"Wen Liu,&nbsp;Xiaojing Li,&nbsp;Chunhong Hu","doi":"10.1007/s00261-026-05472-7","DOIUrl":"10.1007/s00261-026-05472-7","url":null,"abstract":"<div><h3>Purpose</h3><p>To explore MRI-based radiomic, clinical, and sonographic features for constructing models to predict lymph node metastasis (LNM) in endometrial carcinoma (EC) preoperatively and noninvasively.</p><h3>Methods</h3><p>From January 2016 to December 2024, clinical, imaging and pathological information of patients with EC were retrospectively collected at center 1 and 2. Radiomic features extracted from preoperative MRI were screened, a radiomic model was developed and radscore was calculated. Univariate and multivariate analyses were performed with all features to identify independent LNM predictors. Another three models were constructed: a clinical model based on clinical features, an ultrasound model based on features defined by International Endometrial Tumor Analysis, and a combined model integrating all predictors. Receiver operator characteristic curve and DeLong test were employed for evaluating model performance. Clinical decision curve (CDC) and calibration curve were used for assessing the clinical benefit of the models.</p><h3>Results</h3><p>225 patients with EC were included, in which 44 patients were with LNM and 181 patients were without LNM. Statistical analyses showed that radscore, age, CA125, and endometrium thickness (EMT) were predictors for LNM. DeLong test demonstrated that CombinedModel had the superior predictive performance, which was presented as a nomogram, with area under the curve values of 0.895 (95%CI:0.828,0.961),0.870 (95%CI:0.739,1.000), 0.890 (95%CI: 0.766,1.000) for training, internal and external validation set, respectively. CDC and calibration curve of the nomogram demonstrated higher clinical benefit than other models.</p><h3>Conclusion</h3><p>The nomogram comprising age, CA125, radscore, and EMT exhibited the best performance in LNM prediction of patients with EC, making it a valuable tool for decision-making.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5863 - 5874"},"PeriodicalIF":2.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A modified Rim APHE criterion to improve LI-RADS diagnostic performance for primary liver malignancies","authors":"Chunying Feng,&nbsp;Jun Liu,&nbsp;Dawei Yang,&nbsp;Lixue Xu,&nbsp;Min Li,&nbsp;Yan Bao,&nbsp;Jinghui Dong,&nbsp;Jiawen Luo,&nbsp;Qingqing Chen,&nbsp;Rufang Liao,&nbsp;Chenxia Li,&nbsp;Rongpin Wang,&nbsp;Hui Xu,&nbsp;Zhenghan Yang","doi":"10.1007/s00261-026-05551-9","DOIUrl":"10.1007/s00261-026-05551-9","url":null,"abstract":"<div><h3>Purpose</h3><p>To refine the diagnostic criteria for rim arterial phase hyperenhancement (Rim APHE) and to evaluate the impact of this modification on the diagnostic performance for primary liver malignancies.</p><h3>Materials and methods</h3><p>This multicenter, retrospective study included patients with pathologically confirmed primary liver malignancies who underwent preoperative magnetic resonance imaging (MRI) before June 2021. Thirteen different measurement methods for Rim APHE were evaluated to determine the optimal criterion based on diagnostic performance. Two radiologists independently reviewed all observations, assigned Liver Imaging Reporting and Data System (LI-RADS) categories according to version 2018. The diagnostic performance of LI-RADS using original versus modified Rim APHE criteria was compared.</p><h3>Results</h3><p>The study enrolled 272 patients, including 204 with Hepatocellular carcinoma (HCC) (170 men and 34 women; mean age, 57 years ±10) and 68 with non-HCC malignancies (53 men and 15 women; mean age, 56 years ±10). The optimal criterion for Rim APHE was the total thickness of the thickest part of peripheral hyperenhancement to tumor diameter (area under the receiver operating characteristic (ROC) curve [AUC] = 0.852; <i>P</i> &lt; .001). With implementation of the modified Rim APHE criterion, the LR-5 criteria showed significantly superior AUC (0.770 vs. 0.752, <i>p</i> = .007), sensitivity (76.0% vs. 72.5%, <i>p</i> = .016) and accuracy (76.5% vs. 73.9%, <i>p</i> = .016); the LR-M criteria showed higher AUC (0.831 vs. 0.811, <i>p</i> = .004), specificity (92.7% vs. 88.7%, <i>p</i> = .008) and accuracy (87.9% vs. 84.9%, <i>p</i> = .008).</p><h3>Conclusion</h3><p>The optimal criterion for Rim APHE can improve the diagnostic performance for both HCC and non-HCC malignancies.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5875 - 5886"},"PeriodicalIF":2.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of MRCP in characterizing ductal communication and high-risk features in pancreatic cystic lesions","authors":"Michael R. Torkzad,&nbsp;Frank H. Miller,&nbsp;Kumaresan Sandrasegaran,&nbsp;Nancy A. Hammond,&nbsp;Courtney C. Moreno,&nbsp;Pardeep K. Mittal","doi":"10.1007/s00261-026-05543-9","DOIUrl":"10.1007/s00261-026-05543-9","url":null,"abstract":"<div><p>Pancreatic cystic lesions are increasingly detected due to the widespread use of high-resolution cross-sectional imaging, particularly MRI and CT. The reported prevalence of incidental pancreatic cysts is 2% to 13% on CT and 20% to 45% on MRI, reflecting improved imaging sensitivity and an aging population. While most cysts are benign, mucinous lesions such as intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) carry a risk of malignant transformation. MRI with MR cholangiopancreatography (MRCP) is central to evaluating pancreatic cystic lesions, particularly for delineating pancreatic duct anatomy, showing cyst–duct communication, and assessing ductal morphology relevant to malignancy risk. High-resolution 3D MRCP enables detailed visualization of the main and branch ducts and supports differentiation of cyst types, including identification of branch-duct IPMN (BD-IPMN) based on communication with the main pancreatic duct. However, MRCP alone has limitations, such as inability to assess enhancement patterns, vascularity, or subtle mural nodules, which may require contrast-enhanced MRI or endoscopic ultrasound (EUS). Recent advances in MRI technology, including compressed sensing and deep-learning reconstruction, have improved MRCP image quality and enabled abbreviated MRI protocols for surveillance of low-risk cysts. These protocols reduce scan time and cost while keeping diagnostic accuracy but must be applied judiciously to avoid missing subtle high-risk features or concomitant malignancies. This review evaluates the role of MRCP in characterizing ductal communication and high-risk features in pancreatic cystic lesions, discusses technical considerations and diagnostic challenges, and examines the evidence supporting abbreviated MRI protocols. The integration of MRCP into multimodality imaging strategies is emphasized for best risk stratification and clinical management.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5455 - 5468"},"PeriodicalIF":2.3,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}