Clinical Feasibility of 5.0 T MRI/MRCP in Characterizing Pancreatic Cystic Lesions: Comparison with 3.0 T and MDCT

<b>Objectives:</b> To assess the feasibility of 5.0 T magnetic resonance imaging (MRI) in characterizing pancreatic cystic lesions (PCLs), compared with 3.0 T MRI and multidetector computed tomography (MDCT). <b>Methods:</b> Thirty-five patients with PCLs underwent 5.0 T MR alongside 3.0 T MR or MDCT. Two observers measured subjective and objective image quality scores. The consistency of two observers between 5.0 T and 3.0 T was calculated by intraclass correlation coefficients. The characteristics of PCLs and their specific diagnosis, as well as benignity/malignancy, were evaluated across MDCT, 3.0 T, and 5.0 T MRI. <b>Results:</b> The 5.0 T MR demonstrated significantly higher subjective image quality and SNR on T1WI compared to that in 3.0 T MR (<i>p</i> < 0.05). The 5.0 T MRI identified more cyst lesions than the 3.0 T MRI (40 and 32) and MDCT (82 and 56). The sensitivity, specificity, and accuracy for differentiating benign from malignant lesions with 5.0 T MRI (75%, 100%, and 91.4%, respectively) surpassed those of 3.0 T MRI and MDCT. The accuracy of the specific diagnosis of PCLs at 5.0 T MRI (80%) was superior to 3.0 T MRI and MDCT. <b>Conclusions:</b> 5.0 T MRI exhibits certain superiority in delineating details of PCLs and in clinical diagnostic accuracy, outperforming MDCT and 3.0 T MRI while maintaining sufficient image quality.