{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:13:57Z","timestamp":1783350837772,"version":"3.54.6"},"reference-count":43,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background\/Objectives: Accurate risk stratification of intraductal papillary mucinous neoplasms (IPMNs) remains clinically challenging. This study evaluates a structured imaging-based scoring approach for IPMN risk stratification, referred to as the T\u00fcbingen Dignity Score (TDS), and compares its diagnostic performance with established methods. Methods: In this retrospective study, imaging findings from patients with suspected IPMN were analyzed using MRI, CT, and ultrasound. The TDS was applied as an imaging-based scoring system. Diagnostic performance was assessed in a histopathological subset and compared with MRI-based assessment and Fukuoka criteria. Results: MRI showed high sensitivity (94.4%) but limited specificity (57.1%). Fukuoka criteria showed high sensitivity (100%) and high specificity (91.3%) in this cohort, although with a lower positive predictive value. In contrast, the TDS showed high specificity (100%) and positive predictive value, but lower sensitivity (40%), reflecting a different diagnostic profile. These findings indicate a trade-off between sensitivity and specificity across the evaluated approaches. However, the limited number of malignant cases limits the robustness and generalizability of these estimates. Conclusions: The TDS may serve as a complementary, imaging-based tool within a multimodal diagnostic framework for IPMN. Its potential value lies in supporting clinical decision-making in selected cases, particularly where established criteria yield inconclusive results. Given the limited sample size, retrospective single-center design, and exploratory nature of this study, external prospective multicenter validation is required before routine clinical application can be recommended.<\/jats:p>","DOI":"10.3390\/curroncol33070383","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T03:20:21Z","timestamp":1782357621000},"page":"383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Imaging-Based Risk Stratification of IPMN Using a Structured Imaging Score: A Retrospective Proof-of-Concept Study"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6093-4567","authenticated-orcid":false,"given":"Stefano","family":"Fusco","sequence":"first","affiliation":[{"name":"Section of Gastroenterology, Oncology and Palliative Care, Department of Internal Medicine 1, Medical Campus Lake Constance, 88048 Friedrichshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes F.","family":"Digomann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Marienhospital Stuttgart, 70199 Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2367-8699","authenticated-orcid":false,"given":"Sabrina","family":"Gro\u00df","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Gastrointestinal Oncology, Hepatology, Infectiology and Geriatrics, Department of Internal Medicine I, University Hospital of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisar Peter","family":"Malek","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Gastrointestinal Oncology, Hepatology, Infectiology and Geriatrics, Department of Internal Medicine I, University Hospital of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2518-258X","authenticated-orcid":false,"given":"Eckhart","family":"Fr\u00f6hlich","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Gastrointestinal Oncology, Hepatology, Infectiology and Geriatrics, Department of Internal Medicine I, University Hospital of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Gastrointestinal Oncology, Hepatology, Infectiology and Geriatrics, Department of Internal Medicine I, University Hospital of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.pan.2012.04.004","article-title":"International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas","volume":"12","author":"Tanaka","year":"2012","journal-title":"Pancreatology"},{"key":"ref_2","first-page":"1338","article-title":"International consensus guidelines for the management of IPMN and MCN of the pancreas","volume":"104","author":"Tanaka","year":"2007","journal-title":"Nihon Shokakibyo Gakkai Zasshi"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.pan.2017.07.007","article-title":"Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas","volume":"17","author":"Tanaka","year":"2017","journal-title":"Pancreatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.pan.2023.12.009","article-title":"International evidence-based Kyoto guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas","volume":"24","author":"Ohtsuka","year":"2024","journal-title":"Pancreatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1136\/gutjnl-2016-311615","article-title":"Fukuoka criteria accurately predict risk for adverse outcomes during follow-up of pancreatic cysts presumed to be intraductal papillary mucinous neoplasms","volume":"66","author":"Mukewar","year":"2017","journal-title":"Gut"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"(2018). 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