Skip to main content
Top
Published in: Annals of Surgical Oncology 13/2022

15-08-2022 | Computed Tomography | Pancreatic Tumors

Utilization of Natural Language Processing Software to Identify Worrisome Pancreatic Lesions

Authors: Keshav Kooragayala, MD, Connor Crudeli, BS, Ami Kalola, BS, Vipul Bhat, BS, Johanna Lou, MD, Richard Sensenig, MS, Umur Atabek, MD, Karla Echeverria, MD, Young Hong, MD, MPH

Published in: Annals of Surgical Oncology | Issue 13/2022

Login to get access

Abstract

Background

Computed tomography (CT) imaging is routinely obtained for diagnostics, especially in trauma and emergency rooms, often identifying incidental findings. We utilized a natural language processing (NLP) algorithm to quantify the incidence of clinically relevant pancreatic lesions in CT imaging.

Patients and Methods

We utilized the electronic medical record to perform a retrospective chart review of adult patients admitted for trauma to a level 1 tertiary care center between 2010 and 2020 who underwent abdominal CT imaging. An open-source NLP software was used to identify patients with intrapapillary mucinous neoplasms (IPMN), pancreatic cysts, pancreatic ductal dilation, or pancreatic masses after optimizing the algorithm using a test group of patients who underwent pancreatic surgery.

Results

The algorithm identified pancreatic lesions in 27 of 28 patients who underwent pancreatic surgery and excluded 1 patient who had a pure ampullary mass. The study cohort consisted of 18,769 patients who met our inclusion criteria admitted to the hospital. Of this population, 232 were found to have pancreatic lesions of interest. There were 48 (20.7%) patients with concern for IPMN, pancreatic cysts in 36 (15.5%), concerning masses in 30 (12.9%), traumatic findings in 44 (19.0%), pancreatitis in 41 (17.7%), and ductal abnormalities in 19 (18.2%) patients. Prior pancreatic surgery and other findings were identified in 14 (6.0%) patients.

Conclusions

In this study, we propose a novel use of NLP software to identify potentially malignant pancreatic lesions annotated in CT imaging performed for other purposes. This methodology can significantly increase the screening and automated referral for the management of precancerous lesions.
Literature
2.
go back to reference 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(11):2913–21.CrossRefPubMed 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(11):2913–21.CrossRefPubMed
3.
go back to reference Kamisawa T, Isawa T, Koike M, Tsuruta K, Okamoto A. Hematogenous metastases of pancreatic ductal carcinoma. Pancreas. 1995;11(4):345–9.CrossRefPubMed Kamisawa T, Isawa T, Koike M, Tsuruta K, Okamoto A. Hematogenous metastases of pancreatic ductal carcinoma. Pancreas. 1995;11(4):345–9.CrossRefPubMed
5.
7.
go back to reference Sagheb E, Ramazanian T, Tafti AP, et al. Use of natural language processing algorithms to identify common data elements in operative notes for knee arthroplasty. J Arthroplasty. 2021;36(3):922–6.CrossRefPubMed Sagheb E, Ramazanian T, Tafti AP, et al. Use of natural language processing algorithms to identify common data elements in operative notes for knee arthroplasty. J Arthroplasty. 2021;36(3):922–6.CrossRefPubMed
8.
go back to reference Mellia JA, Basta MN, Toyoda Y, et al. Natural language processing in surgery: a systematic review and meta-analysis. Ann Surg. 2021;273(5):900–8.CrossRefPubMed Mellia JA, Basta MN, Toyoda Y, et al. Natural language processing in surgery: a systematic review and meta-analysis. Ann Surg. 2021;273(5):900–8.CrossRefPubMed
9.
go back to reference Swartz J, Koziatek C, Theobald J, Smith S, Iturrate E. Creation of a simple natural language processing tool to support an imaging utilization quality dashboard. Int J Med Inform. 2017;101:93–9.CrossRefPubMed Swartz J, Koziatek C, Theobald J, Smith S, Iturrate E. Creation of a simple natural language processing tool to support an imaging utilization quality dashboard. Int J Med Inform. 2017;101:93–9.CrossRefPubMed
10.
go back to reference Bilaloglu S, Aphinyanaphongs Y, Jones S, Iturrate E, Hochman J, Berger JS. Thrombosis in hospitalized patients with COVID-19 in a New York City health system. JAMA. 2020;324(8):799–801.CrossRefPubMedPubMedCentral Bilaloglu S, Aphinyanaphongs Y, Jones S, Iturrate E, Hochman J, Berger JS. Thrombosis in hospitalized patients with COVID-19 in a New York City health system. JAMA. 2020;324(8):799–801.CrossRefPubMedPubMedCentral
12.
go back to reference Aslanian HR, Lee JH, Canto MI. AGA clinical practice update on pancreas cancer screening in high-risk individuals: expert review. Gastroenterology. 2020;159(1):358–62.CrossRefPubMed Aslanian HR, Lee JH, Canto MI. AGA clinical practice update on pancreas cancer screening in high-risk individuals: expert review. Gastroenterology. 2020;159(1):358–62.CrossRefPubMed
13.
go back to reference Megibow AJ, Baker ME, Morgan DE, et al. Management of incidental pancreatic cysts: a white paper of the ACR incidental findings committee. J Am Coll Radiol. 2017;14(7):911–23.CrossRefPubMed Megibow AJ, Baker ME, Morgan DE, et al. Management of incidental pancreatic cysts: a white paper of the ACR incidental findings committee. J Am Coll Radiol. 2017;14(7):911–23.CrossRefPubMed
14.
go back to reference Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines C. American Gastroenterology A. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 2015;148(4):819–22 (quize812-813).CrossRefPubMed Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines C. American Gastroenterology A. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 2015;148(4):819–22 (quize812-813).CrossRefPubMed
15.
go back to reference Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017;17(5):738–53.CrossRefPubMed Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017;17(5):738–53.CrossRefPubMed
16.
go back to reference Holmstrom AL, Ott KC, Weiss HK, et al. Improving trauma tertiary survey performance and missed injury identification using an education-based quality improvement initiative. J Trauma Acute Care Surg. 2021;90(6):1048–53.CrossRefPubMed Holmstrom AL, Ott KC, Weiss HK, et al. Improving trauma tertiary survey performance and missed injury identification using an education-based quality improvement initiative. J Trauma Acute Care Surg. 2021;90(6):1048–53.CrossRefPubMed
17.
go back to reference Lim PS, Schneider D, Sternlieb J, et al. Process improvement for follow-up radiology report recommendations of lung nodules. BMJ Open Qual. 2019;8(2):e000370.CrossRefPubMedPubMedCentral Lim PS, Schneider D, Sternlieb J, et al. Process improvement for follow-up radiology report recommendations of lung nodules. BMJ Open Qual. 2019;8(2):e000370.CrossRefPubMedPubMedCentral
18.
go back to reference Dyer DS, Zelarney PT, Carr LL, Kern EO. Improvement in follow-up imaging with a patient tracking system and computerized registry for lung nodule management. J Am Coll Radiol. 2021;18(7):937–46.CrossRefPubMed Dyer DS, Zelarney PT, Carr LL, Kern EO. Improvement in follow-up imaging with a patient tracking system and computerized registry for lung nodule management. J Am Coll Radiol. 2021;18(7):937–46.CrossRefPubMed
Metadata
Title
Utilization of Natural Language Processing Software to Identify Worrisome Pancreatic Lesions
Authors
Keshav Kooragayala, MD
Connor Crudeli, BS
Ami Kalola, BS
Vipul Bhat, BS
Johanna Lou, MD
Richard Sensenig, MS
Umur Atabek, MD
Karla Echeverria, MD
Young Hong, MD, MPH
Publication date
15-08-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12391-6

Other articles of this Issue 13/2022

Annals of Surgical Oncology 13/2022 Go to the issue