Publication Name	World Journal of Radiology
Manuscript ID	123527
DOI	10.4329/wjr.123527
Country	Italy

Category	Medicine, Research & Experimental
Manuscript Type	Correspondence
Article Title	Letter to the Editor: De-escalation of branch duct intraductal papillary mucinous neoplasms surveillance
Manuscript Source	Unsolicited Manuscript
All Author List	Cesare Maino and Riccardo Inchingolo
Funding Agency and Grant Number
Corresponding Author	Riccardo Inchingolo, Interventional Radiology Unit, "F Miulli" Regional General Hospital, via di Santeramo, Acquaviva delle Fonti 70021, Italy. riccardoin@hotmail.it
Key Words	Cholangiopancreatography magnetic resonance; Intraductal papillary mucinous neoplasm; Magnetic resonance imaging; Pancreas; Pancreatic ducts; Pancreatic neoplasms
Core Tip	The de-escalation criteria proposed by Hopley et al for branch duct intraductal papillary mucinous neoplasm surveillance are clinically pragmatic and broadly supported by the available evidence. However, their radiological methodology requires greater transparency. Inter-observer variability in magnetic resonance imaging cyst size measurement, the absence of standardised imaging protocols, evolving definitions of worrisome and high-risk features, and the lack of a specified post-de-escalation imaging algorithm represent important unresolved issues. A dedicated pancreatic radiologist within the multidisciplinary team and the adoption of structured reporting standards are essential prerequisites for the safe translation of these findings into routine clinical practice. Addressing these points is meant to strengthen, not undermine, the de-escalation strategy proposed by the authors.
Citation	Maino C, Inchingolo R. Letter to the Editor: De-escalation of branch duct intraductal papillary mucinous neoplasms surveillance. World J Radiol 2026; In press DOI: https://doi.org/10.4329/wjr.123527
PDF	123527-in-press.pdf

Received	2026-05-25 07:43
Peer-Review Started	2026-05-25 07:44
First Decision by Editorial Office Director
Return for Revision	2026-07-07 04:22
Revised	2026-07-14 09:43
Publication Fee Transferred
Second Decision by Editor	2026-07-24 03:17
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-07-28 12:25
Articles in Press	2026-07-28 12:25
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8470 (online)
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