Abstract
Background: Pancreatic ductal adenocarcinoma (PDA) is a highly lethal malignancy, often diagnosed at an advanced stage due to its insidious progression and the absence of effective early detection strategies. Accurate diagnosis and staging are critical for optimizing treatment selection and improving patient survival. Contrast-enhanced computed tomography (CT) remains the diagnostic standard for PDA; however, its sensitivity is limited by interobserver variability and the frequent absence of overt morphological abnormalities in early stage disease. Summary: Artificial intelligence (AI) has emerged as a promising tool for overcoming the inherent limitations of conventional radiologic assessment by leveraging radiomics and deep learning models to extract subtle imaging signatures of PDA that are imperceptible to the human eye. AI-driven models have demonstrated the ability to detect pre-diagnostic PDA on CT scans months to years before clinical presentation by identifying textural and structural changes in the pancreas. Furthermore, automated volumetric pancreas segmentation enhances reproducibility and facilitates the discovery of imaging biomarkers associated with early carcinogenesis. Despite these advances, key challenges remain, including dataset heterogeneity, model interpretability, and prospective validation in real-world clinical settings. Key Messages: AI-driven approaches offer a transformative opportunity to augment CT-based PDA detection, reduce diagnostic uncertainty, and facilitate earlier intervention. However, robust external validation, integration into clinical workflows, and prospective trials are essential to establish AI as a reliable adjunct in PDA diagnosis and staging.