The primary aim of the present study was to assess the interobserver agreement among experienced radiologists who have completed an abdominal fellowship and radiology residents from four medical centers in predicting the malignant potential of pancreatic IPMNs using CT in conjunction with the revised 2017 IAP guidelines. We also sought to evaluate the diagnostic performance of CT for identifying malignant IPMNs based on the reviewers’ experience, focusing on the challenge of enhancing diagnostic consistency and accuracy.