Pancreatic MRI Findings in High-Risk Individuals Compared With Matched Average-Risk Individuals

OBJECTIVES: Pancreatic ductal adenocarcinoma (PDAC) screening is recommended for high-risk individuals (HRI) with familial pancreatic cancer (FPC) or certain pathogenic germline variants (PGVs). Screening MRI commonly identifies pancreatic cystic lesions (PCLs), but comparative data between HRI and average-risk individuals (ARI) are limited. We aimed to quantify and characterize PCL differences between these groups. METHODS: In this retrospective study, 317 HRI were age-, sex-, and race-matched to 634 ARI undergoing MRI/MRCP between July 2018-2019 and 2024. Demographics, genetic factors, and baseline MRI/MRCP outcomes were analyzed. HRI was classified as FPC or PGV±PDAC family history. Statistical analysis compared: all HRI versus all ARI; single HRI subgroups versus matched ARI; and single HRI subgroups versus other HRI. RESULTS: HRIs were more likely to have PCLs than ARIs (50.8% vs. 25.7%, P