简介：Objective:Intra-abdominalfatisariskfactorforpancreaticcancer(PC),butlittleisknownaboutitscontributiontoPCprecursorsknownasintraductalpapillarymucinousneoplasms(IPMNs).Ourgoalwastoevaluatequantitativeradiologicmeasuresofabdominal/visceralobesityaspossiblediagnosticmarkersofIPMNseverity/pathology.Methods:Inacohortof34surgically-resected,pathologically-confirmedIPMNs(17benign;17malignant)withpreoperativeabdominalcomputedtomography(CT)images,wecalculatedbodymassindex(BMI)andfourradiologicmeasuresofobesity:totalabdominalfat(TAF)area,visceralfatarea(VFA),subcutaneousfatarea(SFA),andvisceraltosubcutaneousfatratio(V/S).MeasureswerecomparedbetweengroupsusingWilcoxontwo-sampleexacttestsandothermetrics.Results:MeanBMIforindividualswithmalignantIPMNs(28.9kg/m~2)washigherthanmeanBMIforthosewithbenignIPMNs(25.8kg/m~2)(P=0.045).MeanVFAwashigherforpatientswithmalignantIPMNs(199.3cm~2)comparedtobenignIPMNs(120.4cm~2),P=0.092.V/Swassignificantlyhigher(P=0.013)forpatientswithmalignantversusbenignIPMNs(1.25vs.0.69cm~2),especiallyamongfemales.Theaccuracy,sensitivity,specificity,andpositiveandnegativepredictivevalueofV/SinpredictingmalignantIPMNpathologywere74%,71%,76%,75%,and72%,respectively.Conclusions:PreliminaryfindingssuggestmeasuresofvisceralfatfromroutinemedicalimagesmayhelppredictIPMNpathology,actingaspotentialnoninvasivediagnosticadjunctsformanagementandtargetsforinterventionthatmaybemorebiologically-relevantthanBMI.Furtherinvestigationofgender-specificassociationsinlarger,prospectiveIPMNcohortsiswarrantedtovalidateandexpandupontheseobservations.