Antony Ajith, Mukherjee Sovanlal, Bhinder Khurram, Murlidhar Murlidhar, Zarrintan Armin, Goenka Ajit H
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Divisions of Abdominal and Nuclear Radiology, Nuclear Radiology Research Operations, Enterprise PET/MR Research, Education and Executive Committee, Risk Assessment, Early Detection and Interception (REDI), Mayo Clinic Comprehensive Cancer Center (MCCCC), Rochester, MN, USA.
Visc Med. 2025 May 28:1-9. doi: 10.1159/000546603.
Pancreatic ductal adenocarcinoma (PDA) is a highly lethal malignancy, often diagnosed at an advanced stage due to its insidious progression and the absence of effective early detection strategies. Accurate diagnosis and staging are critical for optimizing treatment selection and improving patient survival. Contrast-enhanced computed tomography (CT) remains the diagnostic standard for PDA; however, its sensitivity is limited by interobserver variability and the frequent absence of overt morphological abnormalities in early stage disease.
Artificial intelligence (AI) has emerged as a promising tool for overcoming the inherent limitations of conventional radiologic assessment by leveraging radiomics and deep learning models to extract subtle imaging signatures of PDA that are imperceptible to the human eye. AI-driven models have demonstrated the ability to detect pre-diagnostic PDA on CT scans months to years before clinical presentation by identifying textural and structural changes in the pancreas. Furthermore, automated volumetric pancreas segmentation enhances reproducibility and facilitates the discovery of imaging biomarkers associated with early carcinogenesis. Despite these advances, key challenges remain, including dataset heterogeneity, model interpretability, and prospective validation in real-world clinical settings.
AI-driven approaches offer a transformative opportunity to augment CT-based PDA detection, reduce diagnostic uncertainty, and facilitate earlier intervention. However, robust external validation, integration into clinical workflows, and prospective trials are essential to establish AI as a reliable adjunct in PDA diagnosis and staging.
胰腺导管腺癌(PDA)是一种高度致命的恶性肿瘤,由于其隐匿性进展以及缺乏有效的早期检测策略,常常在晚期才被诊断出来。准确的诊断和分期对于优化治疗选择和提高患者生存率至关重要。对比增强计算机断层扫描(CT)仍然是PDA的诊断标准;然而,其敏感性受到观察者间差异的限制,并且在疾病早期常常缺乏明显的形态学异常。
人工智能(AI)已成为一种有前景的工具,通过利用放射组学和深度学习模型来提取人眼难以察觉的PDA细微影像特征,从而克服传统放射学评估的固有局限性。人工智能驱动的模型已证明能够通过识别胰腺的纹理和结构变化,在临床表现前数月至数年的CT扫描中检测出预诊断的PDA。此外,自动体积胰腺分割提高了可重复性,并有助于发现与早期致癌作用相关的影像生物标志物。尽管取得了这些进展,但关键挑战仍然存在,包括数据集异质性、模型可解释性以及在现实临床环境中的前瞻性验证。
人工智能驱动的方法为增强基于CT的PDA检测、减少诊断不确定性以及促进早期干预提供了变革性机遇。然而,强大的外部验证、融入临床工作流程以及前瞻性试验对于将人工智能确立为PDA诊断和分期的可靠辅助手段至关重要。