Pancreatic Cyst Management: A Multimodal and Interdisciplinary Approach

With improvements in advanced cross-sectional imaging, there has been an increase in the detection of incidental pancreatic cystic lesions (PCLs). Mucinous PCLs are known precursors of pancreatic cancer, underscoring the need for early detection and appropriate management. When a PCL is initially diagnosed, the next step is to decide among three key management strategies: surgery, surveillance, or reassurance and discharge without follow-up. However, current management guidelines exhibit inconsistencies and limitations, contributing to overtreatment and increased surveillance of PCLs. This review explores the current landscape of PCL management, highlighting the roles of advanced imaging, cyst fluid biomarkers, and developments in artificial intelligence (AI) and radiomics in refining cyst classification, malignancy prediction, and clinical decision-making. Given the heterogeneity of PCLs, we advocate for a multidisciplinary approach that includes diverse clinical expertise and explainable AI model outputs to facilitate accurate risk stratification and individualized patient management.