CT-diagnosed extra-pancreatic extension of pancreatic ductal adenocarcinoma is a more reliable prognostic factor for survival than pathology-diagnosed extension

Toshima, Fumihito; Inoue, Dai; Yoshida, Kotaro; Izumozaki, Akira; Yoneda, Norihide; Minehiro, Kaori; Gabata, Toshifumi

doi:10.1007/s00330-021-08180-6

Cited by 11 publications

(2 citation statements)

References 29 publications

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“…This close association facilitates the tumor's interaction with the vasculature, resulting in a higher probability of (extensive) vascular involvement with adjacent vessels. Besides increasing the likelihood of vascular involvement, extrapancreatic tumor growth also can also result in vascular infiltration or compression, causing occlusion, narrowing, or compromised blood flow, further necessitating diligent scrutiny of these scans by radiologists (Toshima et al 2022). Hence, in resectable cases where less than 25% of the periphery of the tumor segment calculated on all x dimensions is in contact with the pancreas, the model will defer the classification.…”

Section: Decision Deferral Modelmentioning

confidence: 99%

Improving the Reliability of Medical Diagnostic Models through Rule-Based Decision Deferral

Bereska,

Marquering,

Besselink

et al. 2023

AAAI-SS

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Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer, and accurate assessment of tumor resectability is crucial for determining appropriate treatment. AI-based models have shown promise in classifying tumor resectability, but reliability concerns have impeded clinical implementation. We propose extending the AI-based VasQNet model for classifying tumor resectability on AI-generated segmentations of computed tomography scans (CTs) to improve the models’ reliability. This extension allows VasQNet to defer decisions when the AI-generated segmentations violate pre-established rules on vascular anatomy, tumor location, and tumor size. We conducted experiments using CTs of (borderline) resectable and non-resectable PDAC patients. We evaluated the performance of the baseline VasQNet and the extended VasQNet with rule-based decision deferral (RBDD) by comparing their classifications to a ground-truth provided by a radiologist, employing agreement as a metric. Our results demonstrate that the extended VasQNet achieved a significantly higher agreement (90%) with the radiologist’s classification than the baseline VasQNet (67%). Notably, 17/31 (54%) deferred decisions would have been incorrect had they not been deferred. Our study demonstrates the effectiveness of RBDD in improving the reliability of clinical diagnostic models through the exemplification of VasQNet. In conclusion, RBDD can enhance the reliability of clinical diagnostics models, facilitating integration into clinical practice. The documented code is available on GitHub (https://github.com/PHAIR-Consortium/Vessel-Involvement-Quantifier).

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Section: Decision Deferral Modelmentioning

confidence: 99%

Improving the Reliability of Medical Diagnostic Models through Rule-Based Decision Deferral

Bereska,

Marquering,

Besselink

et al. 2023

AAAI-SS

View full text Add to dashboard Cite

show abstract

“…Previous studies have reported different ndings regarding the differences between extrapancreatic extension on CT-scan images and pathological diagnosis. Some have reported a correlation between PV invasion or extrapancreatic extension on CT-scan images and pathological diagnosis [23,24], while other studies have reported no correlation between CT-scan and pathological diagnoses [25]. Mirkin et al [25].…”

Section: Dss Curves According To the New T Category On Ct Images Imme...mentioning

confidence: 99%

Involvement of superior mesenteric vein and superior mesenteric artery is adverse prognostic factors in patients with localized pancreatic ductal adenocarcinoma before and after chemoradiotherapy comparing T category between American Joint Committee on Cancer (AJCC) and Japan Pancreas Society (JPS)

Hayasaki

Mizuno

Nagata

et al. 2022

Preprint

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Background: T category for pancreatic ductal adenocarcinoma (PDAC) in the Classification of Pancreatic Cancer by the Japan Pancreas Society (JPS) is quite different from that in the American Joint Committee on Cancer (AJCC). The aim is to compare prognosis in PDAC patients undergoing chemoradiotherapy (CRT) based on T categories of JPS and AJCC, focusing on extrapancreatic extension. Methods: This study involved 344 PDAC patients who underwent CRT from 2005 to 2019. T-category variables were re-evaluated on computed tomography (CT) images before and after CRT. Disease-specific survival (DSS) was compared based on T categories of JPS and AJCC. Multivariate analysis was performed to identify prognostic factors. Results: Based on T categories of the AJCC on CT-scan images before and after CRT, 5-year DSS of T3 (57.1% and 50%) were better than that of T2 (37.4% and 34.6%). This reversed phenomenon was not observed based on the JPS. The involvement of superior mesenteric vein (PVsm1) and superior mesenteric artery (Asm1) were significant prognostic factors before and after CRT. Our new T classification, which introduced PVsm1 and Asm1, reflected well the prognosis of patients undergoing CRT. Conclusions: The PVsm1 and Asm1 may be practical for T category in PDAC patients undergoing CRT.

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Prediction of postoperative recurrence in resectable pancreatic body/tail adenocarcinoma: a novel risk stratification approach using a CT-based nomogram

Xie,

Liu

et al. 2023

Eur Radiol

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CT-diagnosed extra-pancreatic extension of pancreatic ductal adenocarcinoma is a more reliable prognostic factor for survival than pathology-diagnosed extension

Cited by 11 publications

References 29 publications

Improving the Reliability of Medical Diagnostic Models through Rule-Based Decision Deferral

Improving the Reliability of Medical Diagnostic Models through Rule-Based Decision Deferral

Involvement of superior mesenteric vein and superior mesenteric artery is adverse prognostic factors in patients with localized pancreatic ductal adenocarcinoma before and after chemoradiotherapy comparing T category between American Joint Committee on Cancer (AJCC) and Japan Pancreas Society (JPS)

Prediction of postoperative recurrence in resectable pancreatic body/tail adenocarcinoma: a novel risk stratification approach using a CT-based nomogram

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