Cyst-X: A Multicenter MRI Benchmark for Pancreatic Cyst Risk Stratification and Cross-Institutional AI
Hongyi Pan, Gorkem Durak, Halil Ertugrul Aktas, Ziliang Hong, Zhixiang Wang, Elif KelesDeniz Seyithanoglu, Zheyuan Zhang, Alpay Medetalibeyoglu 等 30 位作者
Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cancer precursors, and guideline-based risk stratification both over-treats indolent lesions and misses progression. We present Cyst-X, a public benchmark of 1,461 T1-weighted (T1W) and T2-weighted (T2W) MRI volumes from 764 patients at seven centers, with expert pancreas masks, risk labels, splits and reference AI risk-prediction models. PanSegNet segmented the pancreas with Dice of 86.34% (T1W) and 89.26% (T2W) on held-out centers. For the primary task, high-risk versus low-risk IPMN, a 3D DenseNet-121 achieved cross-validated AUCs of 74.59% and 73.45%; complementary broad binary and three-class tasks reached 78.67--81.28% and 73.47--75.76%. Because patient images often cannot be pooled across institutions, we also simulated federated learning across the seven centers. On T2W MRI, FedProx was similar to centralized training in center-averaged external AUC (71.00% versus 71.18%) but not in pooled AUC (62.35% versus 77.49%). Radiologist comparisons showed cohort-dependent sensitivity--specificity tradeoffs. Cyst-X supports reproducible method development and identifies within-IPMN risk discrimination and cross-center score comparability as open challenges.
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