Early and Prediagnostic Detection of Pancreatic Cancer from Computed Tomography

Fuente: arXiv
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Main Authors: Li, Wenxuan, Bassi, Pedro R. A. S., Wu, Lizhou, Zhou, Xinze, Zhao, Yuxuan, Chen, Qi, Plotka, Szymon, Lin, Tianyu, Zhu, Zheren, Martin, Marisa, Caskey, Justin, Jiang, Shanshan, Chen, Xiaoxi, Ćwikla, Jaroslaw B., Sankowski, Artur, Wu, Yaping, Decherchi, Sergio, Cavalli, Andrea, Lall, Chandana, Tomasetti, Cristian, Guo, Yaxing, Yu, Xuan, Cai, Yuqing, Qiao, Hualin, Bao, Jie, Hu, Chenhan, Wang, Ximing, Sitek, Arkadiusz, Ding, Kai, Li, Heng, Wang, Meiyun, Yu, Dexin, Zhang, Guang, Yang, Yang, Wang, Kang, Yuille, Alan L., Zhou, Zongwei
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Published: 2026
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author Li, Wenxuan
Bassi, Pedro R. A. S.
Wu, Lizhou
Zhou, Xinze
Zhao, Yuxuan
Chen, Qi
Plotka, Szymon
Lin, Tianyu
Zhu, Zheren
Martin, Marisa
Caskey, Justin
Jiang, Shanshan
Chen, Xiaoxi
Ćwikla, Jaroslaw B.
Sankowski, Artur
Wu, Yaping
Decherchi, Sergio
Cavalli, Andrea
Lall, Chandana
Tomasetti, Cristian
Guo, Yaxing
Yu, Xuan
Cai, Yuqing
Qiao, Hualin
Bao, Jie
Hu, Chenhan
Wang, Ximing
Sitek, Arkadiusz
Ding, Kai
Li, Heng
Wang, Meiyun
Yu, Dexin
Zhang, Guang
Yang, Yang
Wang, Kang
Yuille, Alan L.
Zhou, Zongwei
author_facet Li, Wenxuan
Bassi, Pedro R. A. S.
Wu, Lizhou
Zhou, Xinze
Zhao, Yuxuan
Chen, Qi
Plotka, Szymon
Lin, Tianyu
Zhu, Zheren
Martin, Marisa
Caskey, Justin
Jiang, Shanshan
Chen, Xiaoxi
Ćwikla, Jaroslaw B.
Sankowski, Artur
Wu, Yaping
Decherchi, Sergio
Cavalli, Andrea
Lall, Chandana
Tomasetti, Cristian
Guo, Yaxing
Yu, Xuan
Cai, Yuqing
Qiao, Hualin
Bao, Jie
Hu, Chenhan
Wang, Ximing
Sitek, Arkadiusz
Ding, Kai
Li, Heng
Wang, Meiyun
Yu, Dexin
Zhang, Guang
Yang, Yang
Wang, Kang
Yuille, Alan L.
Zhou, Zongwei
contents Pancreatic ductal adenocarcinoma (PDAC), one of the deadliest solid malignancies, is often detected at a late and inoperable stage. Retrospective reviews of prediagnostic CT scans, when conducted by expert radiologists aware that the patient later developed PDAC, frequently reveal lesions that were previously overlooked. To help detecting these lesions earlier, we developed an automated system named ePAI (early Pancreatic cancer detection with Artificial Intelligence). It was trained on data from 1,598 patients from a single medical center. In the internal test involving 1,009 patients, ePAI achieved an area under the receiver operating characteristic curve (AUC) of 0.939-0.999, a sensitivity of 95.3%, and a specificity of 98.7% for detecting small PDAC less than 2 cm in diameter, precisely localizing PDAC as small as 2 mm. In an external test involving 7,158 patients across 6 centers, ePAI achieved an AUC of 0.918-0.945, a sensitivity of 91.5%, and a specificity of 88.0%, precisely localizing PDAC as small as 5 mm. Importantly, ePAI detected PDACs on prediagnostic CT scans obtained 3 to 36 months before clinical diagnosis that had originally been overlooked by radiologists. It successfully detected and localized PDACs in 75 of 159 patients, with a median lead time of 347 days before clinical diagnosis. Our multi-reader study showed that ePAI significantly outperformed 30 board-certified radiologists by 50.3% (P < 0.05) in sensitivity while maintaining a comparable specificity of 95.4% in detecting PDACs early and prediagnostic. These findings suggest its potential of ePAI as an assistive tool to improve early detection of pancreatic cancer.
format Preprint
id arxiv_https___arxiv_org_abs_2601_22134
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Early and Prediagnostic Detection of Pancreatic Cancer from Computed Tomography
Li, Wenxuan
Bassi, Pedro R. A. S.
Wu, Lizhou
Zhou, Xinze
Zhao, Yuxuan
Chen, Qi
Plotka, Szymon
Lin, Tianyu
Zhu, Zheren
Martin, Marisa
Caskey, Justin
Jiang, Shanshan
Chen, Xiaoxi
Ćwikla, Jaroslaw B.
Sankowski, Artur
Wu, Yaping
Decherchi, Sergio
Cavalli, Andrea
Lall, Chandana
Tomasetti, Cristian
Guo, Yaxing
Yu, Xuan
Cai, Yuqing
Qiao, Hualin
Bao, Jie
Hu, Chenhan
Wang, Ximing
Sitek, Arkadiusz
Ding, Kai
Li, Heng
Wang, Meiyun
Yu, Dexin
Zhang, Guang
Yang, Yang
Wang, Kang
Yuille, Alan L.
Zhou, Zongwei
Computer Vision and Pattern Recognition
Pancreatic ductal adenocarcinoma (PDAC), one of the deadliest solid malignancies, is often detected at a late and inoperable stage. Retrospective reviews of prediagnostic CT scans, when conducted by expert radiologists aware that the patient later developed PDAC, frequently reveal lesions that were previously overlooked. To help detecting these lesions earlier, we developed an automated system named ePAI (early Pancreatic cancer detection with Artificial Intelligence). It was trained on data from 1,598 patients from a single medical center. In the internal test involving 1,009 patients, ePAI achieved an area under the receiver operating characteristic curve (AUC) of 0.939-0.999, a sensitivity of 95.3%, and a specificity of 98.7% for detecting small PDAC less than 2 cm in diameter, precisely localizing PDAC as small as 2 mm. In an external test involving 7,158 patients across 6 centers, ePAI achieved an AUC of 0.918-0.945, a sensitivity of 91.5%, and a specificity of 88.0%, precisely localizing PDAC as small as 5 mm. Importantly, ePAI detected PDACs on prediagnostic CT scans obtained 3 to 36 months before clinical diagnosis that had originally been overlooked by radiologists. It successfully detected and localized PDACs in 75 of 159 patients, with a median lead time of 347 days before clinical diagnosis. Our multi-reader study showed that ePAI significantly outperformed 30 board-certified radiologists by 50.3% (P < 0.05) in sensitivity while maintaining a comparable specificity of 95.4% in detecting PDACs early and prediagnostic. These findings suggest its potential of ePAI as an assistive tool to improve early detection of pancreatic cancer.
title Early and Prediagnostic Detection of Pancreatic Cancer from Computed Tomography
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2601.22134