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While most require periodic radiographic surveillance, some warrant biopsy or surgical excision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a narrative review of the literature focusing on the diagnostic accuracy of imaging and the role of endoscopic and molecular tools in PCL evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cross-sectional imaging correctly classifies cyst type based on morphological features in approximately 50% of cases, with MRI generally outperforming CT. Endoscopic ultrasonography (EUS) is particularly useful when clinical and imaging findings are inconclusive or when high-risk features are present. In selected cases, such features may prompt direct surgical intervention. EUS-guided fine-needle aspiration of cyst fluid for chemical, genetic, and cytological analysis helps differentiate neoplastic mucinous cysts\u2014such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms\u2014from benign, non-mucinous cysts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Accurate diagnosis of PCLs requires a multimodal approach combining high-quality imaging, EUS evaluation, and cyst fluid analysis. Advances in biomarker development hold promise for improving risk stratification and guiding individualized management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10620-025-09320-4","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T09:11:39Z","timestamp":1755853899000},"page":"3246-3259","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Identifying Neoplastic Versus Non-neoplastic Pancreatic Cystic Lesions\u2014What Is the Current Evidence?"],"prefix":"10.1007","volume":"70","author":[{"given":"Arjun","family":"Chatterjee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renan","family":"Prado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifton G.","family":"Fulmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Coppa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Joyce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Mohiuddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhleen","family":"Chahal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"9320_CR1","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1016\/J.DLD.2020.06.038","volume":"52","author":"DG Ribaldone","year":"2020","unstructured":"Ribaldone DG, Bruno M, Gaia S et al. 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