Advancements in early detection of pancreatic cancer: the role of artificial intelligence and novel imaging techniques

Abstract

Early detection is crucial for improving survival rates of pancreatic ductal adenocarcinoma (PDA), yet current diagnostic methods can often fail at this stage. Recently, there has been significant interest in improving risk stratification and developing imaging biomarkers, through novel imaging techniques, and most notably, artificial intelligence (AI) technology. This review provides an overview of these advancements, with a focus on deep learning methods for early detection of PDA.

Keywords: Artificial intelligence; Early detection; Nanoparticle contrast agent; Pancreatic cancer; Photon-counting CT.

Fig. 1

80-Year-old man presented for inguinal hernia assessment. A and C Axial post-contrast portal venous phase images performed on a Siemens 64-slice CT scanner. A Image at the level of the uncinate process demonstrates a 1.3 cm hypodense mass (solid arrows). C The upstream main pancreatic duct is not dilated and is barely seen (dashed arrows). B and D Following biopsy confirming pancreatic ductal adenocarcinoma (PDA), and 13 days after the first CT, a staging pancreatic protocol CT was performed on a photon counting CT (Naeotom Alpha). Axial post-contrast portal venous phase images B at the level of the uncinate process demonstrate a more conspicuous hypodense mass with a sharper demarcation (solid arrows) between the tumor and normal parenchyma. D The upstream normal caliber main pancreatic duct also demonstrates a sharp border and can be well visualized in the head and body (dashed arrows)

Fig. 2

63-Year-old man with an isodense pancreatic head PDA. (A and B) Axial post-contrast portal venous phase images show A a 2.5 cm isodense mass in the pancreatic head (white dashed circle) and B upstream biliary and main pancreatic duct dilation (white solid arrows). C and D Eighteen days after the initial CT and following biliary stent placement (white dashed arrows), the patient underwent a ⁶⁸Ga-FAPI46 PET/CT as a clinical trial participant. Increased ⁶⁸Ga-FAPI46 uptake is noted in the pancreatic head mass (SUV 19 and 17 at 15 and 60 min after injection, respectively) and diffusely within the pancreas where there is subclinical post-obstructive pancreatitis (SUV 18 and 16 at 15 and 60 min after injection, respectively) (black solid arrows)