Analyzing Intraductal Papillary Mucinous Neoplasms Using Artificial Neural Network Methodologic Triangulation

Analyzing Intraductal Papillary Mucinous Neoplasms Using Artificial Neural Network Methodologic Triangulation

Steven Walczak, Jennifer B. Permuth, Vic Velanovich
DOI: 10.4018/IJHISI.2019100102
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Abstract

Intraductal papillary mucinous neoplasms (IPMN) are a type of mucinous pancreatic cyst. IPMN have been shown to be pre-malignant precursors to pancreatic cancer, which has an extremely high mortality rate with average survival less than 1 year. The purpose of this analysis is to utilize methodological triangulation using artificial neural networks and regression to examine the impact and effectiveness of a collection of variables believed to be predictive of malignant IPMN pathology. Results indicate that the triangulation is effective in both finding a new predictive variable and possibly reducing the number of variables needed for predicting if an IPMN is malignant or benign.
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Background

“The category of IPMN was created originally to embrace all mass-forming pre-invasive neoplasia comprising mucinous ductal cells, arising from the native pancreatic ducts” (Fernández–del Castillo & Adsay, 2010, pg. 709). The chief symptoms of individuals with IPMN are: abdominal pain, weight loss, jaundice, nausea, and fatigue and may also be concomitant with diabetes or pancreatitis (Adsay et al., 2002; Fernández–del Castillo & Adsay, 2010; Sohn et al. 2001, 2004). However, the vast majority of patients are asymptomatic and IPMN are discovered incidentally when abdominal imaging is performed for other unrelated problems (Fernández–del Castillo & Adsay, 2010; Sahora & Fernández-del Castillo, 2015). The prevalence of asymptomatic IPMN in patients has been estimated using CT and/or MRI to be from 2.6% to 27% for MD-IPMN or 83% for BD-IPMN (Laffan et al., 2008; D’Angelica et al., 2004; de Pretis et al., 2017; (Pergolini et al., 2017; Salvia et al., 2004).

IPMN are typically detected using CT (computed tomography) or MR (magnetic resonance) imaging (Adsay et al., 2002; Fernández–del Castillo & Adsay, 2010; Sahora & Fernández-del Castillo, 2015). A recent research study in the USA found that IPMN occur in 2.5% of the total population over age 40, with prevalence increasing with age to over 7% and 8% in 70 year olds and 80 year olds respectively (Gardner et al., 2013). Other research, based on autopsies, estimates the prevalence of IPMN at 3.4% of the total population (Tanaka et al., 2006).

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