PanDx: AI-assisted Early Detection of Pancreatic Ductal Adenocarcinoma on Contrast-enhanced CT

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive forms of pancreatic cancer and is often diagnosed at an advanced stage due to subtle early imaging signs. To enable earlier detection and improve clinical decision-making, we propose a coarse-to-fine AI-assisted framework named PanDx for identifying PDAC on contrast-enhanced CT scans. Our approach integrates two novel techniques: (1) distribution-aware stratified ensembling to improve generalization across lesion variations, and (2) peak-scaled lesion candidate extraction to enhance lesion localization precision. PanDx is developed and evaluated as part of the PANORAMA challenge, where it ranked 1st place on the official test set with an AUROC of 0.9263 and an AP of 0.7243. Furthermore, we analyzed failure cases with a radiologist to identify the limitations of AI models on this task and discussed potential future directions for model improvement. Our code and models are publicly available at https://github.com/han-liu/PanDx.