Prediction of malignancy in branch duct (BD)-type intraductal papillary mucinous neoplasms (BD-IPMNs) is difficult. In this retrospective study, we showed the performance of imaging biomarker and biochemical biomarker in identifying the malignant BD-IPMNs. A total of 97 patients with pathological proved BD-IPMNs were included in this study. Imaging data were collected from magnetic resonance imaging (MRI). Malignant BD-IPMNs were defined as those with high grade dysplasia and invasive carcinoma. There were 10 patients with malignant BD-IPMNs (10.3%). Significant difference was found in prevalence of mural nodule and tumor size >3.0 cm between patients with and without malignant BD-IPMNs (44.4% vs 3.1%, P < .01; 80.0% vs 33.3%, P < .01). Significant differences were observed in mural nodule and elevated carbohydrate antigen 19-9 (CA19-9) between patients with and without invasive carcinoma (40.0% vs 7.6, P = .05; 60% vs 15.3%, P = .04). Mural nodule and tumor size >3.0 cm were the independent associated factor for malignant BD-IPMNs. The odds ratio (OR) was 5.22 (95% confidence interval [CI]: 1.04–31.16) for mural nodule and was 6.80 (95% CI: 1.16–39.71) for cyst size >3.0 cm. The combined model of mural nodule and tumor size showed good performance in identifying malignant BD-IPMNs (area under the curve [AUC] = 0.82, 95%CI: 0.67–0.97). Our data show that mural nodule and cystic size can be used as predictor of malignancy in BD-IPMN. The predictive performance is acceptable.

INTRODUCTION: Intrapancreatic fat deposition is related to insulin resistance and type 2 diabetes mellitus. However, the association between intrapancreatic fat deposition and coronary artery disease has not been well studied. In this study, we investigated the associations between intrapancreatic fat deposition alone or in combination with triglyceride-glucose (TYG) index and the risk of coronary artery calcification (CAC) in a general population. METHODS: A total of 9,479 participants who underwent CT scans for lung cancer screening from 2018 to 2020 were included in this study. The TYG index was calculated through the following equation: Ln (fasting glucose [mg/dL] × fasting TG [mg/dL]/2). Pancreatic CT attenuation was used as a marker of intrapancreatic fat deposition. CAC was evaluated on noncardiogram-gated chest CT. RESULTS: CAC was detected in 2,447 of 9,479 participants. The prevalence of CAC was significantly lower in subjects with high pancreatic CT attenuation (37.8% in the first quartile [Q1] vs 17.8% in the fourth quartile [Q4], P < 0.001). Pancreatic CT attenuation was associated with the occurrence of CAC (odds ratio 0.82, 95% confidence interval 0.69–0.97, Q4 vs Q1). The area under the curve of the combination of pancreatic CT attenuation and the TYG index was significantly greater than that of TYG and pancreatic CT attenuation alone in identifying CACs (0.646 vs 0.596 and 0.612, P < 0.001). DISCUSSION: Intrapancreatic fat deposition was associated with CAC, and the combination of pancreatic CT attenuation and the TYG index performed better than TYG or pancreatic CT attenuation alone in identifying CACs.