Cyst-X: A Federated AI System Outperforms Clinical Guidelines to Detect Pancreatic Cancer Precursors and Reduce Unnecessary Surgery

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Main Authors: Pan, Hongyi, Durak, Gorkem, Keles, Elif, Seyithanoglu, Deniz, Zhang, Zheyuan, Medetalibeyoglu, Alpay, Aktas, Halil Ertugrul, Bejar, Andrea Mia, Hong, Ziliang, Taktak, Yavuz, Kartal, Gulbiz Dagoglu, Erturk, Mehmet Sukru, Cebeci, Timurhan, Gonzalez, Maria Jaramillo, Velichko, Yury, Zhao, Lili, Agarunov, Emil, Salanitri, Federica Proietto, Spampinato, Concetto, Tiwari, Pallavi, Xu, Ziyue, Jambawalikar, Sachin, Schoots, Ivo G., Bruno, Marco J., Huang, Chenchan, Bolan, Candice W., Gonda, Tamas, Miller, Frank H., Keswani, Rajesh N., Wallace, Michael B., Bagci, Ulas
Format: Preprint
Published: 2025
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author Pan, Hongyi
Durak, Gorkem
Keles, Elif
Seyithanoglu, Deniz
Zhang, Zheyuan
Medetalibeyoglu, Alpay
Aktas, Halil Ertugrul
Bejar, Andrea Mia
Hong, Ziliang
Taktak, Yavuz
Kartal, Gulbiz Dagoglu
Erturk, Mehmet Sukru
Cebeci, Timurhan
Gonzalez, Maria Jaramillo
Velichko, Yury
Zhao, Lili
Agarunov, Emil
Salanitri, Federica Proietto
Spampinato, Concetto
Tiwari, Pallavi
Xu, Ziyue
Jambawalikar, Sachin
Schoots, Ivo G.
Bruno, Marco J.
Huang, Chenchan
Bolan, Candice W.
Gonda, Tamas
Miller, Frank H.
Keswani, Rajesh N.
Wallace, Michael B.
Bagci, Ulas
author_facet Pan, Hongyi
Durak, Gorkem
Keles, Elif
Seyithanoglu, Deniz
Zhang, Zheyuan
Medetalibeyoglu, Alpay
Aktas, Halil Ertugrul
Bejar, Andrea Mia
Hong, Ziliang
Taktak, Yavuz
Kartal, Gulbiz Dagoglu
Erturk, Mehmet Sukru
Cebeci, Timurhan
Gonzalez, Maria Jaramillo
Velichko, Yury
Zhao, Lili
Agarunov, Emil
Salanitri, Federica Proietto
Spampinato, Concetto
Tiwari, Pallavi
Xu, Ziyue
Jambawalikar, Sachin
Schoots, Ivo G.
Bruno, Marco J.
Huang, Chenchan
Bolan, Candice W.
Gonda, Tamas
Miller, Frank H.
Keswani, Rajesh N.
Wallace, Michael B.
Bagci, Ulas
contents Pancreatic cancer is projected to be the second-deadliest cancer by 2030, making early detection critical. Intraductal papillary mucinous neoplasms (IPMNs), key cancer precursors, present a clinical dilemma, as current guidelines struggle to stratify malignancy risk, leading to unnecessary surgeries or missed diagnoses. Here, we developed Cyst-X, an AI framework for IPMN risk prediction trained on a unique, multi-center dataset of 1,461 MRI scans from 764 patients. Cyst-X achieves significantly higher accuracy (AUC = 0.82) than both the established Kyoto guidelines (AUC = 0.75) and expert radiologists, particularly in correct identification of high-risk lesions. Clinically, this translates to a 20% increase in cancer detection sensitivity (87.8% vs. 64.1%) for high-risk lesions. We demonstrate that this performance is maintained in a federated learning setting, allowing for collaborative model training without compromising patient privacy. To accelerate research in early pancreatic cancer detection, we publicly release the Cyst-X dataset and models, providing the first large-scale, multi-center MRI resource for pancreatic cyst analysis.
format Preprint
id arxiv_https___arxiv_org_abs_2507_22017
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Cyst-X: A Federated AI System Outperforms Clinical Guidelines to Detect Pancreatic Cancer Precursors and Reduce Unnecessary Surgery
Pan, Hongyi
Durak, Gorkem
Keles, Elif
Seyithanoglu, Deniz
Zhang, Zheyuan
Medetalibeyoglu, Alpay
Aktas, Halil Ertugrul
Bejar, Andrea Mia
Hong, Ziliang
Taktak, Yavuz
Kartal, Gulbiz Dagoglu
Erturk, Mehmet Sukru
Cebeci, Timurhan
Gonzalez, Maria Jaramillo
Velichko, Yury
Zhao, Lili
Agarunov, Emil
Salanitri, Federica Proietto
Spampinato, Concetto
Tiwari, Pallavi
Xu, Ziyue
Jambawalikar, Sachin
Schoots, Ivo G.
Bruno, Marco J.
Huang, Chenchan
Bolan, Candice W.
Gonda, Tamas
Miller, Frank H.
Keswani, Rajesh N.
Wallace, Michael B.
Bagci, Ulas
Image and Video Processing
Computer Vision and Pattern Recognition
Pancreatic cancer is projected to be the second-deadliest cancer by 2030, making early detection critical. Intraductal papillary mucinous neoplasms (IPMNs), key cancer precursors, present a clinical dilemma, as current guidelines struggle to stratify malignancy risk, leading to unnecessary surgeries or missed diagnoses. Here, we developed Cyst-X, an AI framework for IPMN risk prediction trained on a unique, multi-center dataset of 1,461 MRI scans from 764 patients. Cyst-X achieves significantly higher accuracy (AUC = 0.82) than both the established Kyoto guidelines (AUC = 0.75) and expert radiologists, particularly in correct identification of high-risk lesions. Clinically, this translates to a 20% increase in cancer detection sensitivity (87.8% vs. 64.1%) for high-risk lesions. We demonstrate that this performance is maintained in a federated learning setting, allowing for collaborative model training without compromising patient privacy. To accelerate research in early pancreatic cancer detection, we publicly release the Cyst-X dataset and models, providing the first large-scale, multi-center MRI resource for pancreatic cyst analysis.
title Cyst-X: A Federated AI System Outperforms Clinical Guidelines to Detect Pancreatic Cancer Precursors and Reduce Unnecessary Surgery
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2507.22017