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Pancreatic cancer is one of the deadliest cancers, with only 9% of patients surviving five years after diagnosis. "That is an abysmally low number, probably the worst in human cancers," says Michael Wallace, M.D., a digestive disease specialist and a researcher within the Center for Individualized Medicine at the Mayo Clinic campus in Florida. "We want to get that rate substantially higher."
Addressing this challenge, Mayo Clinic radiology and gastroenterology experts, in collaboration with computer scientists from the University of Central Florida, are using artificial intelligence (AI) to identify pancreatic cysts at risk of becoming cancerous. This innovative approach has the potential to transform pancreatic cancer outcomes by enabling earlier detection and treatment.
Harnessing AI to Identify High-Risk Cysts
The research focuses on intraductal papillary mucinous neoplasms (IPMNs), precancerous pancreatic cysts often found incidentally during CT or MRI scans. While most cysts are benign, some develop into cancer. Current diagnostic tools, such as cyst size or imaging features, aren’t reliable enough to predict cancer risk accurately.
Mayo Clinic's AI algorithm changes this by learning from scans of cysts that progressed to cancer and those that remained benign.
"The algorithm is able to call attention to cysts that may be of higher risk, bringing it to the attention of the radiologist for detailed review," says Candice Bolan, M.D., chair of the Division of Body MRI in Florida, who helped in the development of the software.
This approach ensures that patients who need closer monitoring or surgical intervention are identified early, potentially saving lives.
Expanding Detection Through Questionnaires and Genetic Testing
Beyond imaging, Mayo Clinic is also using genetic testing and patient questionnaires to evaluate pancreatic cancer risk. These tools help identify individuals with genetic mutations, such as BRCA1 and BRCA2, which not only increase the risk for breast and ovarian cancers but also for pancreatic cancer.
The patient questionnaire — designed in a multidisciplinary collaboration of the Center for Individualized Medicine and the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, and supported by the Florida Pancreas Cancer Coalition and Champions for Hope – flagged 25% of respondents for genetic counseling, uncovering pathogenic variants in several individuals.
The questionnaire goes beyond pancreatic cancer to ask about a family history of other diseases, including breast cancer. "Many people understand that the BRCA1 and BRCA2 mutation can increase your risk for breast and ovarian cancer. But those mutations also increase risk for pancreatic cancer," says Kristin Clift, who coordinates research for the Center for Individualized Medicine.
Among 430 people who completed the questionnaire, three individuals were found to have pathogenic variants associated with pancreatic cancer, including one who was found to have the disease.
"The genetic testing helped determine the best treatment option for that individual. Her sister also came in for genetic testing and was found to have the variant," Clift says. "We were able to put the sister on a screening regimen so that we can catch the cancer earlier if it develops."
A Collaborative Effort to Improve Outcomes
Dr. Wallace, a leader in the initiative, underscores the importance of combining advanced technology like AI with personalized medicine. While AI streamlines cyst risk evaluation, genetic tools enable precise classification of individual risk, ensuring earlier interventions.
The team, funded by the National Institutes of Health, is continuously improving the algorithm by feeding it more data. The goal is for AI to surpass the accuracy of even the best radiologists, making high-quality pancreatic cancer screening accessible worldwide.
By integrating artificial intelligence, genetic insights, and personalized care, Mayo Clinic is paving the way for a brighter future in pancreatic cancer treatment. This collaborative effort demonstrates the power of innovation and teamwork which are essential to Mayo’s efforts to provide the best possible care to patients.
The insights in this post are drawn from article in Mayo Clinic News Network
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