The work Rosenthal had done to annotate CT scans of patients with pancreatic cancer and more by Dana-Farber Cancer Institute

The work was part of a 2018 project to assess the body composition of patients with pancreatic cancer. The team, led by Brian Wolpin, MD, MPH, director of the gastrointestinal cancer center at Dana-Farber, studied the annotated images and discovered that patients with pancreatic cancer often show signs of skeletal muscle wasting at the time of diagnosis.

The finding raised new questions. To answer them, Rosenthal was going to need to annotate a lot more CT scans.

‘I realized this was a great opportunity for automation with AI,’ says Rosenthal, who has a PhD in computer science and is currently assistant director of radiology at Dana-Farber Brigham and Women’s Hospital Pancreas and Biliary Tumor Center. 

Since then, Rosenthal has used the AI tool he developed to analyze more than 100,000 CT scans. Recently, he and Wolpin made another important discovery: Skeletal muscle wasting could be an early sign of pancreatic cancer.

The finding, published in Nature Communications, is part of an ongoing line of work led by Wolpin at the Hale Family Center for Pancreatic Cancer Research at Dana-Farber. The goal is to find signals — in blood, in scans, or in medical records — that would aid in the early detection of pancreatic cancer.

Approximately 80% of patients with pancreatic cancer discover the disease late, when it has already spread and cannot be surgically removed. Of these patients, almost none are still living five years after diagnosis. But when the disease is discovered early, it has the potential to be cured, and about 44% survive for five years.

‘If we’re going to really improve the lives of patients with this cancer, earlier detection has to be part of that program,’ says Wolpin. ‘Treatments are really important, but earlier detection is essential.’

About 10 years ago, Wolpin and colleagues discovered some cases of pancreatic cancer cause diabetes. The pancreas is responsible for secreting enzymes that aid in digestion, so they set out to learn more about how pancreatic cancer affects metabolism.

In mouse studies performed in collaboration with Matthew Vander Heiden’s laboratory at MIT, they noticed a rise in levels of certain amino acids in the blood in the early stages of cancer development. They were coming from the deterioration of muscle and fat.

‘The cancer was causing the pancreas to improperly secrete the enzymes that normally break down food,’ says Wolpin. ‘The mice end up malnourished, leading to muscle and fat loss.’

This finding, published in 2018, also included the work Rosenthal had done to annotate CT scans of patients with pancreatic cancer.”