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UW researchers develop pancreatic cancer screen

Journal of Business

09-26-17

System used to detect often-fatal disease early

Pancreatic cancer has one of the worst prognoses-with a five-year survival rate of 9 percent-in part because there are no telltale symptoms or non-invasive screening tools to catch a tumor before it spreads.

Now, University of Washington researchers are developing a smartphone application that could enable people to screen for pancreatic cancer and other diseases by snapping a selfie.

BiliScreen uses a smartphone camera, computer vision algorithms, and related tools to detect increased bilirubin levels in a person's sclera, or the white part of the eye. The app is described in a paper that's scheduled to be presented this week at Ubicomp 2017, the Association for Computing Machinery's International Joint Conference on Pervasive and Ubiquitous Computing.

One of the earliest symptoms of pancreatic cancer, as well as other diseases, is jaundice, a yellow discoloration of the skin and eyes caused by a buildup of bilirubin in the blood. The ability to detect signs of jaundice when bilirubin levels are minimally elevated, but before they're visible to the naked eye, could enable an entirely new screening program for at-risk individuals.

In an initial clinical study of 70 people, the BiliScreen app, used in conjunction with a 3-D printed box that controls the eye's exposure to light, correctly identified cases of concern 89.7 percent of the time.

"The problem with pancreatic cancer is that by the time you're symptomatic, it's frequently too late," says lead author Alex Mariakakis, a doctoral student at the Paul G. Allen School of Computer Science & Engineering. "The hope is that if people can do this simple test once a month-in the privacy of their own homes-some might catch the disease early enough to undergo treatment that could save their lives."

BiliScreen builds on earlier work from the UWs Ubiquitous Computing Lab, which previously developed BiliCam, a smartphone app that screens for newborn jaundice by taking a picture of a baby's skin.

In collaboration with UW Medicine doctors, the UbiComp lab specializes in using cameras, microphones, and other components of smartphones and tablets to screen for disease.

The blood test that doctors currently use to measure bilirubin levels, which is typically not administered to adults unless there is reason for concern, requires access to a health care professional and is inconvenient for frequent screening researchers contend. BiliScreen is designed to be a tool that could help determine whether someone ought to consult a doctor for further testing. Beyond diagnosis, BiliScreen also potentially could ease the burden on patients with pancreatic cancer who require frequent bilirubin monitoring.

In adults, the whites of the eyes are more sensitive than skin to changes in bilirubin levels, which can be an early warning sign for pancreatic cancer, hepatitis, or the generally harmless Gilbert's syndrome. Unlike skin color, changes in the sclera are more consistent across all races and ethnicities.

Yet by the time people notice the yellowish discoloration in the sclera, bilirubin levels already are well past cause for concern. The UW team wondered if computer vision and machine learning tools could detect those color changes in the eye before humans can see them.

"The eyes are a really interesting gateway into the body-tears can tell you how much glucose you have. Sclera can tell you how much bilirubin is in your blood," says senior author Shwetak Patel, the Washington Research Foundation Entrepreneurship endowed professor in computer science and engineering and electrical engineering. "Our question was: Could we capture some of these changes that might lead to earlier detection with a selfie?"

BiliScreen uses a smartphone's builtin camera and flash to collect pictures of a person's eye as he or she snaps a selfie. The team developed a computer vision system to isolate the white parts of the eye automatically and effectively, which is a valuable tool for medical diagnostics. The app then calculates the color information from the sclera based on the wavelengths of light that are being reflected and absorbed and correlates it with bilirubin levels using machine learning algorithms.

To account for different lighting conditions, the team tested BiliScreen with two different accessories: paper glasses printed with colored squares to help calibrate color and a 3-D printed box that blocks out ambient lighting. Using the app with the box accessory led to slightly better results.

Next steps for the research team include testing the app on a wider range of people at risk for jaundice and underlying conditions, as well as continuing to make usability improvements, including removing the need for accessories like the box and glasses.

"This relatively small initial study shows the technology has promise," says co-author Dr. Jim Taylor, a professor in the UW Medicine Department of Pediatrics whose father died of pancreatic cancer at age 70.

"Pancreatic cancer is a terrible disease with no effective screening right now," Taylor says. "Our goal is to have more people who are unfortunate enough to get pancreatic cancer to be fortunate enough to catch it in time to have surgery that gives them a better chance of survival."

The research was funded by the National Science Foundation, the Coulter Foundation, and endowment funds from the Washington Research Foundation.

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