A Unified Framework for the Detection and Classification of Fatty Pancreas in Ultrasound Images
Authors: Ioan-Tudor-Alexandru Anghel, Ciprian-Mihai Ceausescu, Elena Dana Nedelcu, Elena Raluca Stirban, Camelia Croitoru, Despina Ungureanu, Ana Maria Palan, Gabriela Pop
Organizations: Faculty of Mathematics and Computer Science, University of Bucharest, Bucharest, Romania · Ponderas Academic Hospital, Radiology, Bucharest, Romania · Ponderas Academic Hospital, Internal Medicine, Bucharest, Romania · Ponderas Academic Hospital, Gastroenterology, Bucharest, Romania · Emergency Clinical Hospital Bucharest, Radiology Department, Bucharest
Abstract
Non-alcoholic fatty pancreas disease (NAFPD) is an underdiagnosed condition associated with metabolic syndrome, insulin resistance, and increased risk of pancreatic cancer. Diagnosis typically relies on subjective visual assessment of ultrasound images by clinicians. We propose an end-to-end framework for automatically classifying normal versus fatty pancreas from abdominal ultrasound images. Our method employs a TransUNet-based segmentation architecture with a ResNet encoder and transformer bottleneck to delineate the pancreas and the splenic vein, followed by anatomically-guided patch extraction and patient-level classification through pairwise texture comparison. The feature engineering mimics clinical reasoning by comparing the echogenicity of peri-venous fat to the pancreatic parenchyma, providing an interpretable signal for classification. The segmentation models are initialized via domain-specific transfer learning from a liver segmentation task. We validate the full pipeline on a clinical dataset of 214 abdominal ultrasound images with 107 expert-labeled cases using 5-fold cross-validation. SVM with RBF kernel achieves a mean cross-validated accuracy of 89.7%,±,1.8% and F1 of 0.898,±,0.019, while the unsupervised K-Means baseline reaches 87.8% accuracy, demonstrating that the proposed features capture the relevant clinical signal even without labeled training data. To our knowledge, this is the first end-to-end automated framework for fatty pancreas classification from ultrasound using segmentation-guided texture analysis.
Differentiating non-alcoholic steatohepatitis (NASH) from non-alcoholic fatty liver disease (NAFLD) using ultrasound remains challenging due to subtle tissue alterations and the limited information available in conventional B-mode imaging. In this work, we investigate whether complementary ultrasound representations derived from the same acquisition can improve NASH versus NAFLD classification. Specifically, we combine conventional B-mode ultrasound with physics-guided and local phase-based image representations and evaluate their effectiveness using self-supervised masked autoencoders (MAEs) and graph convolutional networks (GCNs). Experiments were conducted on a multi-site Mayo Clinic cohort consisting of 2,547 liver ultrasound scans from 125 patients. Compared with conventional B-mode ultrasound alone, complementary ultrasound representations consistently improved classification performance, yielding gains of up to 32.4% in accuracy and 91.2% in F1-score. Furthermore, performance improvements were consistently observed across age groups, sex, race, ethnicity,and acquisition sites.
Sabahattin Mert Daloglu, Gokce Bekar, Ceren Coskun +5
Postoperative pancreatic fistula (POPF) is a serious complication after pancreatic resection, increasing morbidity, hospital stay, and healthcare costs. We present an automatic, end-to-end deep learning pipeline-from pancreatic segmentation to classification-for preoperative POPF risk estimation and stratification using preoperative CT scans. A data set with auto-segmented pancreas volumes and surgical outcomes was used to evaluate multiple architectures, including a custom lightweight 3D CNN baseline (CNN3D), R(2+1)D ResNet-18, and ResNet-MC3-18 models. Evaluation across multiple 3D architectures demonstrated promising predictive performance. This approach offers a clinically valuable tool and a methodological benchmark for pancreas-specific CT classification, supporting improved preoperative decision-making in pancreatic surgery.
Accurate determination of pancreatic ductal adenocarcinoma (PDAC) resectability relies on evaluating how the tumor interacts with major peripancreatic vessels on CT imaging, yet expert assessment often shows substantial variability. We introduce a fully automated multimodal deep learning framework that jointly analyzes 3D contrast enhanced CT and structured clinical information to classify patients into the three National Comprehensive Cancer Network (NCCN) resectability categories (upfront resectable, borderline resectable, locally advanced). The approach uses a Swin-UNETR backbone to obtain anatomy aware image representations through auxiliary segmentation of pancreas, tumor, and vascular structures. These features are fused with a compact clinical embedding derived from 17 routinely collected variables and processed by a lightweight classification head. Model training is guided by a dynamic multitask objective that adapts the balance between segmentation and classification based on current tumor Dice performance, promoting feature representations that remain both anatomically informed and discriminative.
Vincent Ochs, Christoph Kuemmerli, Florentin Bieder +12