{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:44:46Z","timestamp":1792104286687,"version":"4.4.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 333 patients, 204 had low-grade dysplasia (LGD), 56 had HGD, and 73 had malignancy. PI decreased with increasing histologic grade (75.6 \u00b1 10.2% in LGD, 74.5 \u00b1 12.0% in HGD, 70.5 \u00b1 12.6% in malignancy;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003). Pancreatic Hounsfield unit standard deviation (HU-SD) was significantly higher in HGD and malignancy than in LGD (25.6 \u00b1 5.9, 29.0 \u00b1 8.7, and 29.6 \u00b1 6.2, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 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;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Quantitative 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-20615-2","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:56:53Z","timestamp":1792101413000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative CT-Derived Imaging Features Improve Preoperative Risk Stratification of Intraductal Papillary Mucinous Neoplasms"],"prefix":"10.1245","author":[{"given":"Tae Seung","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Min","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Ho","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Seok","family":"Bae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Rae","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo Hyun","family":"Paik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wooil","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Ho","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haeryoung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Kon","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Ho","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Hyub","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"9","key":"20615_CR1","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1056\/nejmra2309041","volume":"391","author":"TA Gonda","year":"2024","unstructured":"Gonda TA. 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