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The threshold of MPD diameter in predicting malignancy may be related to the lesion location. This study aimed to separately identify the thresholds of MPD for malignancy of IPMNs separately for the head-neck and body-tail.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>A total of 185 patients with pathologically confirmed IPMNs were included. Patient demographic information, clinical data, and pathological features were obtained from the medical records. Those IPMNs with high-grade dysplasia or with associated invasive carcinoma were considered as malignant tumor. Radiological data including lesion location, tumor size, diameter of the MPD, mural nodule, and IPMN types (main duct, MD; branch duct, BD; and mixed type, MT), were collected on computed tomography or magnetic resonance imaging. Serum carbohydrate antigen 19-9 levels, serum carcinoembryonic antigen levels, and the medical history of diabetes mellitus, chronic cholecystitis, and pancreatitis were also collected.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Malignant IPMNs were detected in 31.6% of 117 patients with lesions in the pancreatic head-neck and 20.9% of 67 patients with lesions in the pancreatic body-tail. In MPD-involved IPMNs, malignancy was observed in 54.1% of patients with lesions in the pancreatic head-neck and 30.8% of patients with lesions in the pancreatic body-tail (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The cutoff value of MPD diameter for malignancy was 6.5\u00a0mm for lesions in the head-neck and 7.7\u00a0mm for lesions in the body-tail in all type of IPMNs. In MPD-involved IPMNs, the threshold was 8.2\u00a0mm for lesion in pancreatic head-neck and 7.7\u00a0mm for lesions in the body-tail. Multivariate analysis confirmed that MPD diameter\u2009\u2265\u20096.5\u00a0mm (pancreatic head-neck) and MPD diameter\u2009\u2265\u20097.7\u00a0mm (pancreatic body-tail) were independent predictors of malignancy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Similar results were observed in MPD-involved IPMNs using 8.2\u00a0mm as a threshold.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The thresholds of the dilated MPD may be associated with IPMNs locations. Thresholds of 6.5\u00a0mm for lesions in the head-neck and 7.7\u00a0mm for lesions in the body-tail were observed. For MPD-involved IPMNs alone, threshold for lesions in the head-neck was close to that in the body-tail.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-022-02577-3","type":"journal-article","created":{"date-parts":[[2022,11,19]],"date-time":"2022-11-19T11:02:59Z","timestamp":1668855779000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Threshold of main pancreatic duct for malignancy in intraductal papillary mucinous neoplasm at head-neck and body-tail"],"prefix":"10.1186","volume":"22","author":[{"given":"Hao","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshuang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyue","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingrong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongqiu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,19]]},"reference":[{"issue":"5","key":"2577_CR1","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, et al. 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During the study, Declaration of Helsinki was adhered to.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare that they have no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"473"}}