Incidental findings during pancreatic cyst surveillance: clinical relevance and implications for MRI…

AI / informaticsAbdominal radiology (New York)· Jul 2026

Incidental findings during pancreatic cyst surveillance: clinical relevance and implications for MRI protocol design.

Timothy Liu, Yiqiu Shen, Hersh Chandarana … Chenchan Huang

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Abdominal & Body ImagingAI / informaticsClinical practiceQ1IF 2.7

Extrapancreatic neoplasms had far higher odds in cyst-other than cyst-only patients.

Incidental findings during pancreatic cyst surveillance: clinical relevance and implications for MRI protocol design.

Timothy Liu … Chenchan Huang

Abdominal radiology (New York) · Jul 2026 · Q1 in Radiology

Purpose

To evaluate the prevalence and clinical relevance of incidental findings detected during pancreatic cyst surveillance and explore their implications for pancreas-focused imaging protocols.

Methods

Were stratified into cyst-only surveillance (cyst-only), cyst surveillance with high-risk pancreatic screening (cyst-HRI), or cyst surveillance with additional clinical indications (cyst-other).

n = 6174 patients

Results

Odds of an incidental other cancer were 14-fold higher with additional clinical indications.

aOR 14.20 (95% CI 5.09 to 39.61)

CI excludes the null - significant

More results

Large language model-reviewer agreement was high (Cohen κ = 0.857 and 0.882).

Incidental findings were identified in 43.0% of examinations and were predominantly nonneoplastic (98.7%), with most not requiring further action (70.2%).

More results

Electronic health record targeted review confirmed 19 extrapancreatic neoplasms, most commonly renal neoplasms (n = 14).

No extrapancreatic neoplasms were identified in cyst-HRI patients (0/446; 95% CI 0.00-0.82%).

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Conclusion · 1 of 2

Clinically significant extrapancreatic neoplasms were rare during pancreatic cyst surveillance, particularly among cyst-only and cyst-HRI patients.

Conclusion · 2 of 2

While this study did not directly assess the diagnostic performance of reduced field-of-view or non-contrast MRI, the low burden of extrapancreatic neoplasms suggests these protocol strategies warrant further evaluation in selected populations.

Incidental findings during pancreatic cyst surveillance: clinical relevance and implications for MRI protocol design.

Incidental findings during pancreatic cyst surveillance: clinical relevance and implications for MRI protocol design.

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