Revisiting Lesion Classification in Pancreatic Cancer: PanIN or IPMN?

3D imaging challenges traditional size-based classification of precancerous lesions in pancreatic ductal adenocarcinoma. Over 1400 lesions meeting size criteria for pancreatic intraepithelial neoplasia (PanIN) were identified in 3D analysis, with a quarter digitally sectioning as intraductal papillary mucinous neoplasms (IPMN). Half of these large lesions were visible on preoperative CT scans. Current classification based on 2D size assessment fails in high-resolution 3D evaluation, necessitating updated guidelines.