MRI improves liver metastasis detection in pancreatic cancer, crucial for surgical decision-making.

• MRI identified additional liver metastases in 2-23% of CT-negative patients and 12-45% of those with indeterminate CT findings.
• The impact on time to surgery was inconsistent, with delays averaging a 5.7-day increase, but cases varied widely.

Surgeons should consider integrating MRI in pre-operative staging to refine patient selection, while awaiting further high-quality studies on its cost-effectiveness.