# Pancreatic Cystic Lesions: From Basic Knowledge to Recent Guidelines

## TL;DR

This review explains how to classify and manage pancreatic cystic lesions, emphasizing imaging techniques and recent advances in risk assessment.

## Contribution

The paper provides an updated overview of PCL management, focusing on imaging and radiomics for improved risk stratification.

## Key findings

- PCLs vary from benign to malignant, requiring accurate classification for proper treatment.
- Imaging techniques like CT, MRI, and endoscopic ultrasound are crucial for diagnosis.
- Radiomics offers new potential for characterizing and stratifying risk in IPMNs.

## Abstract

Pancreatic cystic lesions (PCLs) are increasingly detected due to widespread use of cross-sectional imaging. They encompass a heterogeneous group of lesions, ranging from benign pseudocysts and serous cystic neoplasms (SCNs) to premalignant mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs), as well as rare malignant entities such as solid pseudopapillary epithelial neoplasm (SPENs) and cystic pancreatic neuroendocrine tumors (cystic PanNETs). Management of PCLs depends on their malignant potential; therefore, an accurate classification is essential for optimizing treatment. This narrative review summarizes current knowledge on the epidemiology, imaging characteristics, diagnosis, and management of PCLs, highlighting the role of CT, MRI, MRCP, and endoscopic ultrasound. Recent advances in radiomics for lesion characterization and risk stratification, particularly in IPMNs, are discussed.