{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T09:13:37Z","timestamp":1778663617767,"version":"3.51.4"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences","award":["2023- I2M-2-002"],"award-info":[{"award-number":["2023- I2M-2-002"]}]},{"name":"National High Level Hospital Clinical Research Funding","award":["2022-PUMCH-D-001"],"award-info":[{"award-number":["2022-PUMCH-D-001"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreatic cystic lesions (PCLs) have variable malignant potential, and distinguishing benign from malignant\/premalignant cysts is challenging for optimal management. Trans-abdominal ultrasound (TAUS), a widely available, non-invasive, low-cost first-line pancreatic imaging tool, is underexplored for predicting PCL malignant potential. This study aimed to develop a TAUS feature-based nomogram for this purpose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 161 patients with pathology-confirmed PCLs from December 2012 to July 2021, divided into benign (59 cases) and non-benign (premalignant\/malignant, 102 cases) groups. Relevant clinical characteristics and TAUS features were collected. Least absolute shrinkage and selection operator (LASSO) logistic regression analysis was used to optimize feature selection. Multivariate logistic regression analysis was applied to construct the nomogram. The performance of the nomogram was assessed via receiver operating characteristic curves, calibration curves and decision curve analysis (DCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 26 features collected, 11 features were chosen via LASSO analysis. Multivariate analysis identified echogenicity, the configuration of cysts, solid content and septation\/wall thickening as independent predictors. The prediction nomogram model developed with these four variables showed moderate discriminative performance in differentiating non-benign from benign PCLs, with an area under the curve (AUC) of 0.781. Regarding internal verification, tenfold cross-validation yielded a C-index of 0.749. The Hosmer\u2013Lemeshow test yielded a\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.945, suggesting that the model had a good fit. Additionally, DCA demonstrated good net clinical benefit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study explored the value of TAUS features for predicting the malignant potential of PCLs. The incorporation of TAUS features into a nomogram may offer a potential non-invasive tool to help clinicians in risk stratification during the initial evaluation and follow-up assessment of PCLs patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-026-02325-z","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:57:37Z","timestamp":1775145457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A nomogram for malignancy prediction of pancreatic cystic lesions based on trans-abdominal ultrasound features"],"prefix":"10.1186","volume":"26","author":[{"given":"Liyuan","family":"Ma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"Ji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jionghui","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nengwen","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aonan","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuang","family":"An","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luying","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"issue":"11","key":"2325_CR1","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1038\/s41575-019-0195-x","volume":"16","author":"NCM van Huijgevoort","year":"2019","unstructured":"van Huijgevoort NCM, Del Chiaro M, Wolfgang CL, van Hooft JE, Besselink MG. Diagnosis and management of pancreatic cystic neoplasms: current evidence and guidelines. Nat Rev Gastroenterol Hepatol. 2019;16(11):676\u201389.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"6","key":"2325_CR2","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1148\/rg.256045161","volume":"25","author":"DV Sahani","year":"2005","unstructured":"Sahani DV, Kadavigere R, Saokar A, Fernandez-del Castillo C, Brugge WR, Hahn PF. Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics. 2005;25(6):1471\u201384.","journal-title":"Radiographics"},{"issue":"5","key":"2325_CR3","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.pan.2017.07.007","volume":"17","author":"M Tanaka","year":"2017","unstructured":"Tanaka M, Fern\u00e1ndez-Del Castillo C, Kamisawa T, Jang JY, Levy P, Ohtsuka T, Salvia R, Shimizu Y, Tada M, Wolfgang CL. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017;17(5):738\u201353.","journal-title":"Pancreatology"},{"issue":"12","key":"2325_CR4","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1097\/PAS.0000000000000533","volume":"39","author":"O Basturk","year":"2015","unstructured":"Basturk O, Hong SM, Wood LD, Adsay NV, Albores-Saavedra J, Biankin AV, Brosens LA, Fukushima N, Goggins M, Hruban RH, et al. A Revised Classification System and Recommendations From the Baltimore Consensus Meeting for Neoplastic Precursor Lesions in the Pancreas. Am J Surg Pathol. 2015;39(12):1730\u201341.","journal-title":"Am J Surg Pathol"},{"issue":"5","key":"2325_CR5","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1136\/gutjnl-2018-316027","volume":"67","author":"The European Study Group on Cystic Tumours of the Pancreas.","year":"2018","unstructured":"The European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018;67(5):789\u2013804.","journal-title":"Gut"},{"issue":"9","key":"2325_CR6","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/j.dld.2013.01.010","volume":"45","author":"M Del Chiaro","year":"2013","unstructured":"Del Chiaro M, Verbeke C, Salvia R, Kl\u00f6ppel G, Werner J, McKay C, Friess H, Manfredi R, Van Cutsem E, L\u00f6hr M, et al. European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis. 2013;45(9):703\u201311.","journal-title":"Dig Liver Dis"},{"issue":"3","key":"2325_CR7","doi-asserted-by":"publisher","first-page":"423","DOI":"10.5858\/133.3.423","volume":"133","author":"O Basturk","year":"2009","unstructured":"Basturk O, Coban I, Adsay NV. Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med. 2009;133(3):423\u201338.","journal-title":"Arch Pathol Lab Med"},{"issue":"2","key":"2325_CR8","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/his.13975","volume":"76","author":"ID Nagtegaal","year":"2020","unstructured":"Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, Washington KM, Carneiro F, Cree IA. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020;76(2):182\u20138.","journal-title":"Histopathology"},{"issue":"1","key":"2325_CR9","doi-asserted-by":"publisher","first-page":"47","DOI":"10.5858\/arpa.2019-0308-RA","volume":"144","author":"A Abdelkader","year":"2020","unstructured":"Abdelkader A, Hunt B, Hartley CP, Panarelli NC, Giorgadze T. Cystic Lesions of the Pancreas: Differential Diagnosis and Cytologic-Histologic Correlation. Arch Pathol Lab Med. 2020;144(1):47\u201361.","journal-title":"Arch Pathol Lab Med"},{"key":"2325_CR10","doi-asserted-by":"crossref","unstructured":"Jiang J, Chao WL, Culp S, Krishna SG. Artificial intelligence in the diagnosis and treatment of pancreatic cystic lesions and adenocarcinoma. Cancers (Basel) 2023;15(9).","DOI":"10.3390\/cancers15092410"},{"issue":"2","key":"2325_CR11","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1136\/flgastro-2018-101076","volume":"10","author":"BM Stutchfield","year":"2019","unstructured":"Stutchfield BM, Nayar M, Penman ID. Pancreatic cystic lesions: risk stratification and management based on recent guidelines. Frontline Gastroenterol. 2019;10(2):182\u20137.","journal-title":"Frontline Gastroenterol"},{"issue":"3","key":"2325_CR12","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s10396-019-00975-x","volume":"47","author":"S Hashimoto","year":"2020","unstructured":"Hashimoto S, Hirooka Y, Kawabe N, Nakaoka K, Yoshioka K. Role of transabdominal ultrasonography in the diagnosis of pancreatic cystic lesions. J Med Ultrason (2001). 2020;47(3):389\u201399.","journal-title":"J Med Ultrason (2001)"},{"issue":"2","key":"2325_CR13","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/s00261-006-9009-z","volume":"32","author":"M Bertolotto","year":"2007","unstructured":"Bertolotto M, D\u2019Onofrio M, Martone E, Malago R, Pozzi Mucelli R. Ultrasonography of the pancreas. 3. Doppler imaging. Abdom Imaging. 2007;32(2):161\u201370.","journal-title":"Abdom Imaging"},{"issue":"1","key":"2325_CR14","doi-asserted-by":"publisher","first-page":"188318","DOI":"10.1016\/j.bbcan.2019.188318","volume":"1873","author":"J Carmicheal","year":"2020","unstructured":"Carmicheal J, Patel A, Dalal V, Atri P, Dhaliwal AS, Wittel UA, Malafa MP, Talmon G, Swanson BJ, Singh S, et al. Elevating pancreatic cystic lesion stratification: Current and future pancreatic cancer biomarker(s). Biochim Biophys Acta Rev Cancer. 2020;1873(1):188318.","journal-title":"Biochim Biophys Acta Rev Cancer"},{"key":"2325_CR15","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.canlet.2019.10.023","volume":"469","author":"V Dalal","year":"2020","unstructured":"Dalal V, Carmicheal J, Dhaliwal A, Jain M, Kaur S, Batra SK. Radiomics in stratification of pancreatic cystic lesions: Machine learning in action. Cancer Lett. 2020;469:228\u201337.","journal-title":"Cancer Lett"},{"key":"2325_CR16","unstructured":"Malagelada J. Pancreatic Cystic Lesions. WGO Global Guideline 2019; 2019."},{"issue":"4","key":"2325_CR17","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1053\/j.gastro.2015.01.015","volume":"148","author":"SS Vege","year":"2015","unstructured":"Vege SS, Ziring B, Jain R, Moayyedi P. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 2015;148(4):819\u201322. quize812-813.","journal-title":"Gastroenterology"},{"key":"2325_CR18","doi-asserted-by":"crossref","unstructured":"Hentschel V, Beckmann J, Kratzer W, Arnold F, Seufferlein T, Walter B, Kleger A, Muller M. A systematic comparative study on the diagnostic value of transabdominal ultrasound in patients with pancreatic cystic lesions. J Clin Med 2022;11(20).","DOI":"10.3390\/jcm11206176"},{"key":"2325_CR19","doi-asserted-by":"crossref","unstructured":"Fan Z, Yan K, Wang Y, Qiu J, Wu W, Yang L, Chen M. Application of contrast-enhanced ultrasound in cystic pancreatic lesions using a simplified classification diagnostic criterion. Biomed Res Int. 2015;2015:974621.","DOI":"10.1155\/2015\/974621"},{"issue":"6","key":"2325_CR20","doi-asserted-by":"publisher","first-page":"2637","DOI":"10.1007\/s00261-021-02954-8","volume":"46","author":"S Chen","year":"2021","unstructured":"Chen S, Ren S, Guo K, Daniels MJ, Wang Z, Chen R. Preoperative differentiation of serous cystic neoplasms from mucin-producing pancreatic cystic neoplasms using a CT-based radiomics nomogram. Abdom Radiol (NY). 2021;46(6):2637\u201346.","journal-title":"Abdom Radiol (NY)"},{"issue":"20","key":"2325_CR21","doi-asserted-by":"publisher","first-page":"e2409488","DOI":"10.1002\/advs.202409488","volume":"12","author":"S Cheng","year":"2025","unstructured":"Cheng S, Hu G, Zhang S, Lv R, Sun L, Zhang Z, Jin Z, Wu Y, Huang C, Ye L, et al. Machine Learning-Based Radiomics in Malignancy Prediction of Pancreatic Cystic Lesions: Evidence from Cyst Fluid Multi-Omics. Adv Sci (Weinh). 2025;12(20):e2409488.","journal-title":"Adv Sci (Weinh)"},{"key":"2325_CR22","doi-asserted-by":"crossref","unstructured":"Syailendra EA, Lopez-Ramirez F, Tixier F, Blanco A, Arshad H, Yasrab M, Rahmatullah ZF, Javed AA, He J, Lennon AM, et al. Evaluating the role of the main pancreatic duct in intraductal papillary mucinous neoplasm grading: a multi-structure radiomics-based machine learning approach. Diagn Interv Imag. 2026.","DOI":"10.1016\/j.diii.2026.02.002"},{"key":"2325_CR23","doi-asserted-by":"publisher","first-page":"153303382311709","DOI":"10.1177\/15330338231170942","volume":"22","author":"H Zhang","year":"2023","unstructured":"Zhang H, Cao Y, Ren S, Guo K, Zhang Y, Lin T, Wang Y, Chen X, Wang Z. Threshold of Main Pancreatic Duct Diameter in Identifying Malignant Intraductal Papillary Mucinous Neoplasm by Magnetic Resonance Imaging. Technol Cancer Res Treat. 2023;22:15330338231170942.","journal-title":"Technol Cancer Res Treat"},{"key":"2325_CR24","unstructured":"Xu Y, Chen Y, Cheng J, Yang T, Zhang Y, Xu J, Chen J. Development and validation of a new model for predicting malignant pancreatic cystic lesions based on clinical and EUS characteristics. Scand J Gastroenterol 2025:1\u201310."},{"issue":"1","key":"2325_CR25","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.1186\/s12885-025-15249-8","volume":"25","author":"Z Yuan","year":"2025","unstructured":"Yuan Z, Shi Y, Chen S, Yang J, Chen J, Li J, Pu Y, Ma X, Yang Q, Zhao X, et al. Deep learning based on ultrasound for differential diagnosis of pancreatic serous cystic neoplasm and mucinous cystic neoplasm. BMC Cancer. 2025;25(1):1891.","journal-title":"BMC Cancer"},{"issue":"5","key":"2325_CR26","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1007\/s00261-017-1269-2","volume":"43","author":"MRM Sun","year":"2018","unstructured":"Sun MRM, Strickland CD, Tamjeedi B, Brook A, Mortele KJ, Brook OR, Kane RA, Siewert B. Utility of transabdominal ultrasound for surveillance of known pancreatic cystic lesions: prospective evaluation with MRI as reference standard. Abdom Radiol (NY). 2018;43(5):1180\u201392.","journal-title":"Abdom Radiol (NY)"},{"issue":"6","key":"2325_CR27","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.2214\/AJR.20.22965","volume":"216","author":"MH Yu","year":"2021","unstructured":"Yu MH, Kim JH, Kang HJ, Choi SY, Park YS, Lee ES, Park HJ. Transabdominal Ultrasound for Follow-Up of Incidentally Detected Low-Risk Pancreatic Cysts: A Prospective Multicenter Study. AJR Am J Roentgenol. 2021;216(6):1521\u20139.","journal-title":"AJR Am J Roentgenol"},{"key":"2325_CR28","doi-asserted-by":"crossref","unstructured":"Wang Y, Wang Y, Fan Z, Shan J, Yan K. The value of contrast-enhanced ultrasound classification in diagnosis of pancreatic cystic lesions. Biomed Res Int. 2019;2019:5698140.","DOI":"10.1155\/2019\/5698140"},{"key":"2325_CR29","doi-asserted-by":"crossref","unstructured":"Li YJ, Lee GH, Yang MJ, Hwang JC, Yoo BM, Kim SS, Lim SG, Kim JH. Diagnostic yield of transabdominal ultrasonography for evaluation of pancreatic cystic lesions compared with endoscopic ultrasonography. J Clin Med. 2021;10(19).","DOI":"10.3390\/jcm10194616"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-026-02325-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02325-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02325-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:39:38Z","timestamp":1778661578000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12880-026-02325-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2325"],"URL":"https:\/\/doi.org\/10.1186\/s12880-026-02325-z","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]},"assertion":[{"value":"8 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study followed the Declaration of Helsinki and was approved by the Institutional Review Board \/ Ethics Committee of Peking Union Medical College Hospital (approval number: K4829). Due to the retrospective nature of the study, the requirement for informed consent was waived by the same ethics committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication was obtained from all participants whose clinical data are presented in the manuscript and supplementary materials.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"249"}}