SUPPLEMENTAL DIGITAL CONTENT 2. Patients Design Characteristics of the Included Articles Author Selection Criteria Number of Patients

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SUPPLEMENTAL DIGITAL CONTENT 2. Patients Design Characteristics of the Included Articles

Author Selection Criteria Number of

Patients^*

Age^† Sex Ratio (male:female)

Patient Population^‡

Lesion Characterization for Diagnosis BD-

IPMN^§

Lesion Criteria/Diagnosis Criteria^|| Distribution of Patients^¶

Distribution BD-IPMN Patients^# Other Data^**

Ikeuchi²¹ Inclusion: patients with BD who had been periodically followed-up.

145 33 resected 112 non-resected

66.3 (10.2) Range: 29-89

79:66 - US, EUS, CT,

MRCP

Size cyst, MPD, MN, location

WE classified IPMN into the main duct type without multilocular dilatation of the branch duct, and the branch duct type

145 BD-IPMN Mean diameter of MDP: 2.2+2.3 Median diameter of mural nodes: 1.6+5.3 Mean diameter of cystic lesions: 20.1+13.0

Only in fatal cases; 3 in head and 1 in tail.

Kanno²² Inclusion: patients with BD-IPMN. 159 44 resected 115 non-resected

68.8 (10.7) 96:63 Unclear EUS, CT, MRI and

ERCP

Diagnosis of IPMN was made when a pancreatic cyst > 1 cm was found to communicate with

the main pancreatic duct by EUS and one or more additional imaging studies including CT, MRI, ERCP.

The type of tumor was based on EUS and/or ERCP; BD- IPMN was defined as a mucin-producing tumor showing cystic dilatation of the pancreatic duct branches.

159 BD-IPMN MPD (mm) 8.7 ± 1.1 (n = 12) 4.6 ± 3.6 (n = 140) Pooled mean MPD: 4.9+3.5

Dilated branch (mm) 47.2 ± 4.3 (N = 12) 27.4 ± 14.2 (N = 140)

Pooled mean dilated branch: 29.0+13.7 Mural nodule (mm) 25.8 ± 4.1 N = 12) 3.9 ± 3.5 (N = 140)Pooled mean mural node:

5.6+3.6

Concomitant:

Head 4, body 2, tail 1

Sawai²³ Inclusion: presence SB-IPMN with at least 2y FU, availability findings from serial imag and clinical details Exclusion: inadequate imaging, resection and death

63 (38 – 84) 58:45 93 asymptomatic at diagnosis

EUS, CT, ERCP, MRCP, IDUS, POPS

SB-IPMN defined as dilated side-branch lesions with ductal communication, presence of mucin in main duct or side- branch on ERCP.

103 BD-IPMN Diameter of mural node (mm): 18 (n = 103).

Median diameter lesions (mm): 18.0 (4–50) (n = 103)

-

Tanno⁸ Inclusion: patients with BD-IPMN who had no mural nodes and fulfilled the diagnostic criteria

89 11 resected 75 non-resected 3 chemo

74 (42 – 88) 56:33 Symptomatic: 1 Asymptomatic: 88

EUS, CT, ERCP, MRCP

Diagnosis of BD-IPMN was made when dilated cyst >10mm, communication between cyst and MPD and presence of mucin was seen by ERCP. The diagnosis was confirmed by CT.

89 BD-IPMN Diameter of mural node (mm): 4 (n = 89).

Median diameter cystic lesion (mm): 20 (11–

65) (n = 89).

Head: 22, tail: 40, multiple: 17 Multifocal: 17 Tanno²⁴ Inclusion: patients with BD-IPMN

Exclusion: patients without ERP and the presence of

MCN/pseudocysts.

67.3 (0.7) 110:58 - EUS, CT, ERP,

MRCP

BD-IPMN diagnosis was based on dilated cyst >10mm, communication between cyst and MPD and the presence of mucin by ERP, in combination with CT, EUS and/or MRCP.

168 BD-IPMN Mural node: 16 (n = 168)

Mean diameter of MPD (mm): 4.5 ± 0.2; (n = 168).

Median diameter of cystic lesion (mm): 22.0

± 0.8 (n = 168).

Head: 85, tail: 51, multiple: 32

Kang²⁵ Inclusion: patients with BD-IPMN, confirmed by radiologic imaging, who were followed >3 months.

Exclusion: unacceptable FU data, cyst >30mm, detectable MN or initial MPD >5mm

62.6 (9.18) 111:90 Symptomatic: 40 US, EUS, CT, ERCP, MRCP

Diagnosis of BD-IPMN was based on dilated branch pancreatic ducts appearing as cluster of small cysts with grapelike appearance, a multilocular cyst with papillary projections, or single cystic lesion with lobulated/irregular margin, communicating with MPD. The communication between BD-IPMN and MPD was identified by CT, MRCP or ERCP.

201 BD-IPMN Mural node: 0 (n = 201).

Mean diameter of MPD (mm): 2.0 ± 0.8; (n = 201)

± 6.2; (n = 201)

Head: 101, tail: 100 Unifocal: 74, multifocal: 127

Kawakubo²⁶ Inclusion: patients with IPMN, confirmed by radiological imaging.

Exclusion: FU<1y, indication for surgery resection at diagnosis.

67.7 (9.4) 361:281 Symptomatic: 24 Asymptomatic: 618

EUS, CT, MRCP, ERCP, EUS

MD-IPMN and BD-IPMN were radiologically defined according to consensus guidelines. BD-IPMN diagnosis was made when presence of pancreatic cystic lesions obviously communicating with MPD.

614 BD-IPMN 28 MD-IPMN

Mural node: 54 (n = 642).

Median diameter of MPD (mm): 2 (1–25); (n

= 642).

Median size of IPMNs (mm): 16 (2–80); (n = 642).

Head: 268, tail/body:

209 Unifocal: 477, Multifocal: 165 Maguchi²⁷ Inclusion: patients with BD-IPMN,

without MN based on EUS Exclusion: FU<1 year, MPD

>10mm, histologically diagnosed as non-IPMN, apparent MN at diagnosis.

US, EUS, CT, MRCP

Definition of IPMN was based on visualization of patulous ampulla of Vater on EUS, filling defects in pancreatic duct on ERCP, or cystic lesions communicating with MPD on EUS, MRCP and/or CT. BD-IPMN was defined as grapelike multilocular cystic lesion communicating with MPD <10mm.

Patients with MPD size of >6mm: 20 (n = 349).

= 349)

Median diameter of cystic lesion (mm): 19 (3–60); (n = 349)

Head: 193 Unifocal: 238, Multifocal: 111

Uehara²⁸ Inclusion: patients with BD-IPMN without MN or a MN<9mm Exclusion: MN>10mm or positive result on cytological examination of pancreatic juice.

US, EUS, CT, ERCP

BD-IPMN suggested by US, EUS or CT and were confirmed by dilated branch duct with a minimum size of 10mm and mucus in it on ERCP.

100 BD-IPMN Median diameter of mural node (mm): 4.4 (3–5); (n = 5)

Median diameter of main duct (mm): 3.8 (1–

8); (n = 100)

Median diameter of cystic lesion (mm): 21 (10–60); (n = 100)

Head: 56, tail: 44 Unifocal: 32, Multifocal: 68

Arlix²⁹ Inclusion: BD-IPMN without radiological signs of malignancy and had >2 imaging exams.

EUS, CT, ERCP, MRCP

Diagnosis of BD-IPMN was based on uni-/multilocular lesions, with grapelike appearance that communicate with MPD. They were confirmed when observed using a minimum

Patients with a MPD size of >6mm: 0 Pooled median diameter of MPD: 2.55 ±

Head: 28, body: 3, tail:

0 Unifocal: 27,

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Exclusion: patients with MPD- IPMN or combination of MPD- and BD-IPMN, radiological signs of malignancy, chronic calcifying pancreatitis.

of 2 of the following imaging modalities: CT, EUS, MRCP or ERCP.

Communication between cyst and MPD observed by EUS, MRCP of ERCP was a prerequisite.

0.55; (n = 49).

Median diameter of cystic lesion (mm): 11.5 (3.4–25); (n = 47)

Multifocal: 20

Bae¹⁶ Inclusion: patients with presumed BD-IPMN.

Exclusion: MPD>6mm.

EUS, CT, ERCP, MRI

BD-IPMN were diagnosed when uni-/multilocular lesions with grapelike appearance communicating with pancreatic ducts, but without any dilatation of MPD >6mm, by CT, MRI, EUS and ERCP.

Pooled median diameter cystic lesion (mm):

24.6; (n = 186).

Not described

Khannoussi³⁰ Inclusion: BD-IPMN diagnosed and FU>5 year.

Exclusion: signs suggesting malignant transformation at initial work-up or during first 60months of FU, FU<60 months.

61 (30 – 76) 6:47 - EUS, CT, ERCP,

MRCP (additional eUS-FNA)

The diagnosis of BD-IPMN was based on the presence of one or

several BD dilatation(s) or pancreatic cystic lesions clearly communicating with pancreatic ducts seen at CT, MRI, MRCP, ERCP or EUS.

Patients with MPD involvement: n = 0 4 groups:

1. Unchanged imaging features (12 mm) (n = 38)

2. Increased size of cyst (10mm) (n = 8) 3. Appearance of MN (22mm) (n = 5) 4. invasive carcinoma (28 & 39mm) (n = 2)

Not described

Ohno¹² Inclusion: asymptomatic BD-IPMN without dilatation of the MPD and obvious MN, with a FU >12 months.

Exclusion: malign-related findings.

65 (9.0) 77:66 Symptomatic: 0

Asymptomatic: 142

CE-EUS, ERP Low-risk BD-IPMN was defined as cyst ≤29mm, MPD

≤5mm and mural nodes ≤4mm by CE-EUS.

High-risk BD-IPMN was defined as deviating from the low- risk image findings.

MD-IPMN was defined as IPMNs with grossly involving MPD with dilatation of MPD ≥10mm or with mural nodes.

BD-IPMN was defined as IPMN with dilated branch with or without mural nodules on cystic wall.

143 BD-IPMN Median size of mural node (mm): 1.9 ± 1.0;

(n = 142)

Patients with MPD size of >6mm: 0 (n = 142) Median diameter of MPD (mm): 2.5 ± 1.2; (n

= 142)

± 9.6; (n = 142)

Location: not described Unifocal: 96, multifocal: 46

Kim³¹ Exclusion: MD-IPMNs, other cystic lesions (MCN, pseudocyst, serous cystadenoma), unsure diagnosis of IPMN, MPD>6mm, signs of pancreatic malignancy

EUS, CT, MRCP The pathognomic findings of BD-IPMN include:

communication between ≥1 pancreatic cysts and MPD, without dilatation/mild dilatation (2-6mm), mucin secretion from ampulla of Vater. MD-IPMN was based on segmental or diffuse dilatation of the MPD without other cause of obstruction. Based on EUS, CT and MRCP imaging.

Median diameter of mural node (mm): 9.4 ± 4.9; (n = 13)

Patients with dilatation of MPD: 7 (n = 104).

Pooled median diameter of cystic lesion (mm): 20.7 ± 9.3; (n = 104).

Head: 51, body: 23, tail: 19

Unifocal: 93, multifocal: 11

Matsuzaki³² Inclusion: patients with BD-IPMN Exclusion: patients with MD- IPMN, mixed-IPMN, pancreatic cancer or chronic pancreatitis

476 0 resected

63.95 (13.4) (both groups)

244:232 Symptomatic: 0 MRI, MRCP BD-IPMN was considered when a cystic pancreatic mass communicated with MPD through a small channel on MRI with MRCP.

154 BD-IPMN 322 other (without BD- IPMN)

Median diameter of MPD (mm): 2.35 ± 0.95;

(n = 119).

± 11.6; (n = 119).

Head 75, body: 74, tail: 35

Sahora¹⁴ Inclusion: clinical diagnosis of BD- IPMN, confirmed by imaging, cyst fluid analysis, consistent cytology and >1y FU.

Exclusion: <1y FU.

EUS, CT, MRI, MRCP

Was classified as BD-IPMN when radiological duct communication was seen on CT and/or MRI with MRCP, cyst fluid analysis showing elevated CEA by FNA, consistent cytology and/or multifocality.

Largest diameter of cystic lesion (mm): 19 ± 10; (n = 563).

Head: 195, neck: 54, tail: 88, body: 134 Unifocal: 296, Multifocal: 267 Kamata¹³ Inclusion: patients suspected to

have IPMN, who had their first examinations with EUS, US, CT and MRCP/MRI.

Exclusion: cystic lesions <5mm 167 58 resected 5 chemo 92 non-resected 12 non FU

US, EUS, CT, MRI, MRCP

IPMN was defined as dilatation of the MPD or its branches.

It was defined as MD-IPMN if the MPD ≥6mm. It was defined as BD-IPMN if the branch duct was dilated and communicated with the pancreatic duct without MPD dilatation.

The lesions were also examined for presence of mural nodules.

= 11).

Median diameter of branch-duct size (mm):

15 (8–28); (n = 11).

Median diameter of cystic lesion (mm): 24 (11–50); (n = 11).

Head: 114, tail: 53

Kobayashi³³ Inclusion: patients with BD-IPMN with mural nodules, indication for FU, FU >1 year and imaging at least twice.

Exclusion: patients with MD- IPMN, FU<1y and histologically non-IPMN.

EUS, CT, ERCP, MRCP

Diagnosis of IPMN was made when dilated MPD or a cystically dilated branch duct was seen in association with mucin from the major or minor papilla or mobile filling defects in the pancreatic duct on ERP, or when multilocular cystic lesions were seen on EUS, MRCP and/or CT.

BD-IPMN was defined as where main lesion was a cystically dilated branch duct with MPD diameter <10mm

53 BD-IPMN Median diameter of mural node (mm): 3 ± 1.6; (n = 53).

Mean maximum size of cystic lesion (mm):

22 ± 0.9; (n = 53).

Mean diameter of MPD (mm): 3.9 ± 1.4; (n = 53).

Mandai³⁴ Inclusion: patients with BD-IPMN

& mixed-IPMN with a FU >1 year.

300 15 resected 285 non-resected (including 5 with chemo)

71.6 (37 – 92)

129:171 - US, EUS, MRCP BD-IPMN was diagnosed when pancreatic cysts of >5mm in diameter in continuity with the MPD were seen on imaging studies. Confirmation of mucin production by ERCP was not a prerequisite for the diagnosis IPMN. Maximum cyst size and MPD were measured by EUS and MRCP, the presence or absence of mural nodules was determined by EUS.

286 BD-IPMN 14 mixed-IPMN

Pooled median diameter of MPD (mm): 2.65

± 1.4; (n = 300).

Pooled median diameter of cystic lesion (mm): 17.3 ± 10.9; (n = 300).

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Nougaret³⁵ Inclusion: patients with pancreatic cysts with FU imaging of >1 year.

Exclusion: patients with symptoms at diagnosis, FU <1 year, chronic pancreatitis, pseudocyst, mucinous cystadenoma, MD-IPMN/mixed- IPMN and/or radiological signs of malignancy.

64 (12) 144:157 Symptomatic: 0 Asymptomatic: 301

CT, MRI Lesions were classified into following risk categories:

1. Probable benign lesion: typical aspect of serous cystadenoma, lesion <20mm uni-/bilocular (thin wall, no mural nodules)

2. Indeterminate lesion: uni-/bilocular lesion (20-30mm), multilocular lesion ≤30mm (thin wall, no mural nodules) 3. Probably malignant lesion: any lesion >30mm, lesion with thick septation, mural nodules or solid mass.

230 BD-IPMN 71 other

Median diameter of cystic lesion (mm): 15.5 (n = 301).

Unifocal: 178 multifocal: 123

Kawada¹⁷ Inclusion: patients with BD-IPMN Exclusion: patients with MD- IPMN, IPMN with mural nodules at initial examination or FU<1 year.

515 (total, maar table: 108 patients 19 resected

67 (6) 64:44 Not described ERP (+ (E)US), CT IPMN were diagnosed when dilated orifrice of duodenal papilla, secretion of mucus during duodenoscopy were seen, or filling defects in the MPD during ERP indicating presence of mucus. Classification of MD- or BD-IPMN was according to the location of the main tumor. Cyst and MPD were measured by MD-CT, a mural node by US or EUS.

515 BD-IPMN (108 in table)

Mural nodules: 0 (n = 515).

Pooled median diameter of MPD (mm): 3.55

± 1.9; (n = 108).

Pooled median diameter of cystic lesion (mm): 20 ± 10.6; (n = 108).

Head: 55 Multiple: 70

Kwong³⁶ Inclusion: patients with suspected BD-IPMN without high risk stigmata.

Exclusion: patients with high risk features, chronic pancreatitis, prior diagnosis of pancreatic cancer, suspected serous cystadenomas, acute pancreatitis 6 months prior to cyst discovery or pancreatic surgery <6 months before cyst discovery.

EUS, CT, MRI BD-IPMN was diagnosed based on presence of uni- /multilocular pancreatic cysts and a non-dilated (≤5mm) MPD on EUS.

Patients with MPD >6mm: 0 (n = 284).

± 10.7; (n = 284).

Head: 131, body/tail:

153

Lawson³⁷ Inclusion: patients with pancreatic cysts ≥18 years with features consistent of BD-IPMN on EUS.

Exclusion: cysts not consistent with BD-IPMN, history of pancreatic cancer, chronic pancreatitis, suspected pseudocyst, von Hippel- Lindau disease or <1 year FU.

67.4 292:369 Symptomatic: 218

Asymptomatic: 443

EUS, CT, MRI MD-IPMN: isolated segmental or diffuse dilatation of pancreatic duct ≥5mm.

MCN: unilocular cyst ≥30mm in size located within the body or tail of female patients.

SCN: unilocular cyst with honeycomb appearance, with normal pancreatic duct caliber.

BD-IPMN: unilocular cyst <30mm in size or multifocal cysts located anywhere within pancreas with normal pancreatic duct.

The diagnosis was made by EUS and FNA cytology

583 BD-IPMN 78 mixed-IPMN

Mural nodule: 25 (n = 250).

Diameter of MPD ≥10mm: 12 (n = 250) Pooled median diameter of cystic lesion (mm): 22 ± 10.9; (n = 661).

Head: 308, body/tail:

353 Unifocal: 375 Multifocal: 286

Malleo³⁸ Inclusion: patients with BD-IPMN, with minimum FU of 1 year.

Exclusion: patients with an unclear radiological diagnosis or lost to FU.

EUS (+FNA), MRI, MRCP

BD-IPMNs were defined as uni-/multifocal cystic lesions of

≥10mm, communicating with a MPD <5mm, or showing CEA ≥200ng/ml, or showing consistent cytology. This was imaged by MRI/MRCP. EUS (+ FNA) was performed at physician’s discretion.

Head: 299 Unifocal: 248 Multifocal: 321

Pezzilli¹ Inclusion: patients with BD-IPMN.

Exclusion: patients who underwent operation during FU (they were excluded from subsequent evaluation).

EUS, MRI, MRCP Diagnosis of BD-IPMN was reached when vague clinical signs (weight loss, diarrhea, abdominal discomfort, asthenia), symptoms not related to the disease (hematuria),

abnormalities in laboratory investigations, or an attack of acute biliary pancreatitis

101 BD-IPMN Mural node: not described.

± 8.9; (n = 101).

Head: 20, body: 20, tail: 8,

head & body: 16

Rosenblatt³⁹ Inclusion: clinical characteristics of IPMN on imaging, with an interval surveillance ≥1 year.

Exclusion: inadequate FU, pancreatic cysts that met criteria other than IPMN, potential high risk features (MD-/mixed-IPMN, baseline mural node, thickened cyst wall or an initial cyst size >3cm).

68.3 50:81 Symptomatic: 24

Asymptomatic: 107

EUS, CT, MRI, MRCP

Diagnosis of unifocal IPMN was defined as a single cyst communicating with the pancreatic duct. Multifocal (MF- )IPMN was defined as at least 2 synchronous or metachronous IPMN cysts during FU. Synchronous cysts were those present initially at baseline imaging.

Metachronous was identified when at least 1 new cyst arose during FU.

The diagnosis was made by EUS, CT or MRI/MRCP.

Main-duct or mixed-IPMN was diagnosed when there was involvement of the MPD.

Pooled median diameter of cystic lesion (mm): 11.8 (n = 131).

Unifocal: 54 Multifocal: 77

Sahora⁴⁰ Inclusion: patients with histopathological confirmed IPMN or followed for presumed IPMN.

Exclusion: patients undergoing single consultation, without further FU.

725

400 resected 325 non-resected

67 (11) 325:400 - EUS, CT, MRI Unresected cystic lesions were assumed IPMNs when there was main duct dilatation, a pancreatic cyst with radiological duct communication to MPD, cyst fluid analysis >200ng/ml, consistent cytology and/or presence of multiple pancreatic cysts.

529 BD-IPMN 49 MD-IPMN 147 mixed- IPMN

Mural node: not described.

Median diameter of MPD (mm): 9 (2–100);

(n = 147).

Median diameter of MPD (mm): 30 (10–90);

(n = 49).

Median diameter of cystic lesion (mm): 25

Location: not described Unifocal: 435 Multifocal: 290

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(6–86); (n = 529).

Crippa⁴¹ Inclusion: patients with IPMN with worrisome features/high risk stigmata undergoing non-operative management.

Exclusion: patients with locally advanced or metastatic tumors or FU <12 months.

281 36 resected

EUS, MDCT, ERCP, MRI/MRCP

Definitive diagnosis of IPMN based on histological or cytological diagnosis after FNA or biopsy during EUS/ERCP.

BD-IPMN: presence of 1 or more dilated branch duct(s) (>10mm) communicating with non-dilated MPD (<5mm) MD-IPMN: presence of dilated MPD (>5mm) with no dilatation of its secondary ducts.

Mixed-IPMN: presence of a dilated MPD (>5mm) communicating with one or more dilated branch duct(s).

The worrisome features and high risk stigmata were defined according to the ICG-II criteria.

159 BD-IPMN 23 MD-IPMN 99 mixed-IPMN

Patients with MPD size >10mm: 31 (281, all in MD-/mixed-IPMN group).

= 159).

= 122).

= 281).

Total pop: head, body- tail, head-body: 162, 677, 10.

For BD-IPMN: 101, 43, 5

Total pop:

Unifocal & multifocal:

139, 138 For BD: 79, 80

Nagata⁴² Inclusion: patients who underwent MD-CT or MRCP for IPMNs.

Exclusion: patients undergone 1 MDCT/MRCP, 2 studies in <3 months FU, with pancreatic/biliary cancer at the initial diagnosis, who underwent surgery immediately following initial diagnosis, or patients with a history of pancreatitis.

72 (64 – 78) 137:148 - US, EUS, MDCT,

ERCP, MRI/MRCP

Diagnosis of IPMN was defined as presence of a connection to the MPD. A cyst was defined as a cystic dilatation of side BD’s or the MPD.

MD-IPMN: segmental or diffuse dilatation of MPD of >5mm without other causes of obstruction.

BD-IPMN: pancreatic cyst >5mm communicating with the MPD.

The maximum diameter of cyst and MPD was measured by MD-CT or MRCP.

Diagnosis of pancreatic cancer was based on histopathologic or cytologic examination or resected specimen, biopsy or tumor brush with ERCP or US.

Mural node: 5 (n = 285)

Patients with MPD size of >6mm: 7 (n = 285).

Median diameter of MPD (mm): 2 (1.7–2.8);

(n = 285).

Ingkakul⁹ Inclusion: patients with IPMN treated by surgical resection or watched without resection

236 68.2 (9.57)

(combined groups, excluding MD-IPMN)

108:92 (200 BP patients)

Symptomatic: 124 Asymptomatic: 76

EUS, CT, ERCP, MRI/MRCP

IPMNs were diagnosed macroscopically by CT, MRI/MRCP, EUS, and/or ERCP and microscopically by pathologic examination of the resected specimens

Mural node in branch duct: 1 (with IPMN + DC), 33 (IPMN alone).

Patients with MPD size of >6mm: 6 (with IPMN + DC), 51 (with IPMN alone).

± 10.6; (IPMN+DC).

± 14.9; (IPMN alone).

IPMNs: head 12, body

& tail 8

DC: head 8, body &

tail 14

Mori⁴³ Inclusion: patients with BD-IPMN 211 69 resected 142 non-resected

68 (11) 100:111 Symptomatic: 137 Asymptomatic: 74

EUS, CE-CT, ERCP, MRI, MRCP

Solitary BD-IPMN was defined as IPMN exclusively involving BD and consisting of a grape-like collection of small cysts, with no other cysts.

Diagnosis of multifocal BD-IPMN was based on: ≥2 cystic lesions that communicated with the MPD.

These findings were evaluated based on MRCP. The size of cysts and MPD were examined by CT, MRI/MRCP and/or EUS.

Median diameter of MPD (mm): 4.0 ± 2.4; (n

= 211).

Median diameter of cystic lesion (mm): 22 ± 15; (n = 211).

Head: 160, body-tail:

135 Unifocal: 169 Multifocal: 42

*Number of patients included in total in the study.

†mean (SD) or median (range)

‡Patient population (symptomatic:asymptomatic).

§Lesions characterized or confirmed by which imaging (US, EUS, CT, ERCP, MRI, other).

||Criteria used by imaging modality.

¶Distribution of patients (BD-IPMN, MD-IPMN, Mixed-IPMN, other).

#Distribution of patients with BD-IPMN for definitions of high and low risk patients (number of patients with mural nodes or diameter of mural nodes, number of patients with dilatation of main pancreatic duct > 6 mm or diameter of main pancreatic duct and diameter lesions (mean and/or maximum size).

**Other data such as location of cystic lesions (head, neck, tail) and focality (unifocal, multifocal).