Uehara H, Abe Y, Kai Y, et al. - The results of this study demonstrate that mural nodules of 10 mm or more and positive cytology were independent predictors of malignancy in main duct intraductal papillary mucinous neoplasms (MD-IPMNs).

• Researchers enrolled a total of 26 benign MD-IPMNs (7 resected and 19 nonresected MD-IPMNs) and 32 malignant MD-IPMNs (31 resected and 1 non resected MD-IPMN).

• A significant difference in sizes of the main pancreatic duct (MPD) and mural nodule and the result of cytology was found between benign and malignant groups.

• As per the findings, 15 mm and 10 mm were the cutoff values of MPD and mural nodule sizes with areas under the curve (AUC) of 0.66 and 0.86, respectively.

• The findings indicated that mural nodule of 10 mm or more (OR, 8.32; 95% CI, 1.13-61.2; P=0.038) and positive cytology (OR, 42.5; 95% CI, 4.10-439; P=0.002) were shown to be independent predictors of malignancy by multivariate analysis.

• The sensitivities, specificities, and overall accuracy for malignancy were 94%, 85%, and 90%, respectively, when MD-IPMNs that had either of the predictors were diagnosed to be malignant.