Iranian Journal of Medical Sciences

Document Type : Original Article(s)

Authors

1 Department of Physiology and Medical Physics, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran

2 Department of Surgery, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran

3 Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran

5 Radiation Sciences Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

10.30476/ijms.2025.105971.4207

Abstract

Background: Pancreatic adenocarcinoma is one of the most aggressive and lethal cancers, with a poor prognosis primarily due to late-stage diagnosis. Improving the accuracy of pancreatic cancer diagnosis is crucial for enhancing survival outcomes, yet the sensitivity of conventional diagnostic methods remains a significant challenge. This study aims to evaluate the effectiveness of radiomics features extracted from Computed Tomography (CT) imaging, combined with machine learning models, for the detection of pancreatic adenocarcinoma.
Methods: A retrospective dataset from Baqiyatallah Hospital, Tehran, Iran (2024) of 100 participants (50 with pancreatic adenocarcinoma (primarily stages II-III) and 50 healthy controls) was used. CT images were acquired with a three-phase protocol, and radiomics features were extracted using 3D Slicer software. Three classifiers—Support Vector Machine (SVM), Logistic Regression (LR), and Random Forest (RF)—were employed, with feature selection methods including Recursive Feature Elimination (RFE), Mutual Information (MI), and Least Absolute Shrinkage and Selection Operator (LASSO). Model performance was assessed using accuracy, precision, sensitivity, F1 score, and area under the curve (AUC).
Results: The SVM classifier with LASSO feature selection achieved the highest performance, with an accuracy of 0.83 and an AUC of 0.89. LR and RF also demonstrated strong results, with LASSO providing the best feature selection for both classifiers. SHAP analysis revealed that textural features such as gray-level-non-uniformity and run-length-non-uniformity were the most important drivers for distinguishing pancreatic cancer from normal tissue. 
Conclusion: Radiomics-based machine learning models show promise for improving the diagnosis of pancreatic adenocarcinoma. The combination of LASSO and powerful classifiers such as SVM, LR, and RF offers a robust framework for non-invasive, accurate diagnostic tools.

Highlights

Amin Talebi (Google Scholar)
Zeinab Shankayi (Google Scholar)

Keywords

  1. McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS. Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018;24:4846-61. doi: 10.3748/wjg.v24.i43.4846. PubMed PMID: 30487695; PubMed Central PMCID: PMC6250924.
  2. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014;74:2913-21. doi: 10.1158/0008-5472.CAN-14-0155. PubMed PMID: 24840647.
  3. Ye C, Sadula A, Ren S, Guo X, Yuan M, Yuan C, et al. The prognostic value of CA19-9 response after neoadjuvant therapy in patients with pancreatic cancer: a systematic review and pooled analysis. Cancer Chemother Pharmacol. 2020;86:731-40. doi: 10.1007/s00280-020-04165-2. PubMed PMID: 33047181.
  4. Kaur S, Baine MJ, Jain M, Sasson AR, Batra SK. Early diagnosis of pancreatic cancer: challenges and new developments. Biomark Med. 2012;6:597-612. doi: 10.2217/bmm.12.69. PubMed PMID: 23075238; PubMed Central PMCID: PMC3546485.
  5. Lambin P, Rios-Velazquez E, Leijenaar R, Carvalho S, van Stiphout RG, Granton P, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48:441-6. doi: 10.1016/j.ejca.2011.11.036. PubMed PMID: 22257792; PubMed Central PMCID: PMC4533986.
  6. Aerts HJ, Velazquez ER, Leijenaar RT, Parmar C, Grossmann P, Carvalho S, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun. 2014;5:4006. doi: 10.1038/ncomms5006. PubMed PMID: 24892406; PubMed Central PMCID: PMC4059926.
  7. Anijdan S, Reiazi R, Tafti HF, Moslemi D, Moghadamnia A, Paydar R. Application of radiomics in radiotherapy: challenges and future prospects. Caspian J Pediatr. 2022;8:127-34. doi: 10.22088/jbums.24.1.127.
  8. Preuss K, Thach N, Liang X, Baine M, Chen J, Zhang C, et al. Using Quantitative Imaging for Personalized Medicine in Pancreatic Cancer: A Review of Radiomics and Deep Learning Applications. Cancers (Basel). 2022;14. doi: 10.3390/cancers14071654. PubMed PMID: 35406426; PubMed Central PMCID: PMC8997008.
  9. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67:93-9. doi: 10.3322/caac.21388. PubMed PMID: 28094848.
  10. Python Software Foundation. Python 3.14 documentation. Beaverton (OR): Python Software Foundation; 2024 [cited 2025]. Available from: https://docs.python.org/3.14/
  11. Mukherjee S, Patra A, Khasawneh H, Korfiatis P, Rajamohan N, Suman G, et al. Radiomics-based Machine-learning Models Can Detect Pancreatic Cancer on Prediagnostic Computed Tomography Scans at a Substantial Lead Time Before Clinical Diagnosis. Gastroenterology. 2022;163:1435-46. doi: 10.1053/j.gastro.2022.06.066. PubMed PMID: 35788343; PubMed Central PMCID: PMC12285712.
  12. Huang Y, Zhang H, Ding Q, Chen D, Zhang X, Weng S, et al. Comparison of multiple machine learning models for predicting prognosis of pancreatic ductal adenocarcinoma based on contrast-enhanced CT radiomics and clinical features. Front Oncol. 2024;14:1419297. doi: 10.3389/fonc.2024.1419297. PubMed PMID: 39605884; PubMed Central PMCID: PMC11598923.
  13. Toyama Y, Hotta M, Motoi F, Takanami K, Minamimoto R, Takase K. Prognostic value of FDG-PET radiomics with machine learning in pancreatic cancer. Sci Rep. 2020;10:17024. doi: 10.1038/s41598-020-73237-3. PubMed PMID: 33046736; PubMed Central PMCID: PMC7550575.
  14. Kim HS, Kim YJ, Kim KG, Park JS. Preoperative CT texture features predict prognosis after curative resection in pancreatic cancer. Sci Rep. 2019;9:17389. doi: 10.1038/s41598-019-53831-w. PubMed PMID: 31757989; PubMed Central PMCID: PMC6874598.
  15. Qiu JJ, Yin J, Qian W, Liu JH, Huang ZX, Yu HP, et al. A Novel Multiresolution-Statistical Texture Analysis Architecture: Radiomics-Aided Diagnosis of PDAC Based on Plain CT Images. IEEE Trans Med Imaging. 2021;40:12-25. doi: 10.1109/TMI.2020.3021254. PubMed PMID: 32877335.
  16. Chen PT, Chang D, Yen H, Liu KL, Huang SY, Roth H, et al. Radiomic Features at CT Can Distinguish Pancreatic Cancer from Noncancerous Pancreas. Radiol Imaging Cancer. 2021;3:e210010. doi: 10.1148/rycan.2021210010. PubMed PMID: 34241550; PubMed Central PMCID: PMC8344348.
  17. Guo C, Zhuge X, Wang Q, Xiao W, Wang Z, Wang Z, et al. The differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma: the values of CT imaging features and texture analysis. Cancer Imaging. 2018;18:37. doi: 10.1186/s40644-018-0170-8. PubMed PMID: 30333055; PubMed Central PMCID: PMC6192319.
  18. Nasief H, Zheng C, Schott D, Hall W, Tsai S, Erickson B, et al. A machine learning based delta-radiomics process for early prediction of treatment response of pancreatic cancer. NPJ Precis Oncol. 2019;3:25. doi: 10.1038/s41698-019-0096-z. PubMed PMID: 31602401; PubMed Central PMCID: PMC6778189.
  19. Zhang C, Peng J, Wang L, Wang Y, Chen W, Sun MW, et al. A deep learning-powered diagnostic model for acute pancreatitis. BMC Med Imaging. 2024;24:154. doi: 10.1186/s12880-024-01339-9. PubMed PMID: 38902660; PubMed Central PMCID: PMC11188273.
  20. Li J, Fu C, Zhao S, Pu Y, Yang F, Zeng S, et al. The progress of PET/MRI in clinical management of patients with pancreatic malignant lesions. Front Oncol. 2023;13:920896. doi: 10.3389/fonc.2023.920896. PubMed PMID: 37188192; PubMed Central PMCID: PMC10175752.