PancDS in Real-World Practice: A Prospective Multicenter Validation of a Clinical Decision-Support System…

Cohort studyAdvanced science (Weinheim, Baden-Wurttemberg, Germany)· Aug 2026

PancDS in Real-World Practice: A Prospective Multicenter Validation of a Clinical Decision-Support System Bridging Experience Gaps in Pancreatic Lesion Diagnosis.

Zhibo Wang, Weinuo Qu, Wenwen Cai … Zhen Li

Medical Imaging AICohort studyDiagnosisQ1IF 14.1

Decision-support system accurately distinguished pancreatic ductal adenocarcinoma from mass-forming pancreatitis prospectively

PancDS in Real-World Practice: A Prospective Multicenter Validation of a Clinical Decision-Support System Bridging Experience Gaps in Pancreatic Lesion Diagnosis.

Zhibo Wang … Zhen Li

Advanced science (Weinheim, Baden-Wurttemberg, Germany) · Aug 2026 · Q1 in General Medicine

Background

Distinguishing pancreatic ductal adenocarcinoma (pancreatic ductal adenocarcinoma) from mass-forming pancreatitis (mass-forming pancreatitis) is challenging due to imaging mimicry and reader-dependent variability.

Methods

In a retrospective multicenter cohort of 1006 consecutive patients with pathologically confirmed resectable pancreatic ductal adenocarcinoma or mass-forming pancreatitis (2014-2023), 634 patients from Tongji Hospital were used for training/internal testing, and 372 patients from four independent hospitals for external testing.

n = 634 patients

Results

PancDS correctly classified the tumor type in nearly all patients tested

AUC 0.87 (95% CI 0.72 to 0.98)

null 0

0.72

0.98

CI excludes the null - significant

More results

PancDS achieves internal and external AUCs of 0.936 (95% CI: 0.864-0.993) and 0.881 (95% CI: 0.833-0.924), respectively.

More results

In a reader study, PancDS significantly improves diagnostic accuracy and sensitivity, with the largest gains in intermediate and junior radiologists (P < 0.001) and minimal case-level deterioration (1.5-3.9%), functioning as a diagnostic equalizer.

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Conclusion

This practice-tested, prospectively evaluated system provides a reliable tool for PDAC-MFP differentiation, potentially informing surgical decision-making and enhancing diagnostic equity across diverse clinical environments.

PancDS in Real-World Practice: A Prospective Multicenter Validation of a Clinical Decision-Support System Bridging Experience Gaps in Pancreatic Lesion Diagnosis.

PancDS in Real-World Practice: A Prospective Multicenter Validation of a Clinical Decision-Support System Bridging Experience Gaps in Pancreatic Lesion Diagnosis.

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