Researchers from the University of Washington, in Seattle, are in the process of developing a smartphone app that may be able to transform selfies into a method of catching pancreatic cancer in its very early stages, which in turn could greatly improve outcomes.
Jaundice is an early symptom of pancreatic cancer. It causes yellowing of the skin and sclera, owing to a build-up of bilirubin in the blood. It only becomes readily visible after the disease is advanced.
This is where the new app, dubbed BiliScreen, could make a difference: the smartphone app is able to capture pictures of the sclera in a patient’s eye and produce an estimate of the bilirubin level, before jaundice is visible.
A clinical study that included 70 healthy volunteers compared findings using the BiliScreen app with results from the blood test that is normally used to assess serum bilirubin. In the study, the app was used in conjunction with a 3-D printed box that controls the eye’s exposure to light.
The researchers found that the BiliScreen could identify “cases of concern” with a sensitivity of 89.7% and a specificity of 96.8% when used with the box accessory.
Lead author Alex Mariakakis, a doctoral student at the Paul G. Allen School of Computer Science and Engineering, University of Washington, cautioned that despite the encouraging results, the device is not yet ready for prime time.
“We are not yet at the point where we can distribute the app for diagnostic/screening purposes,” he told Medscape Medical News. “We’re planning a larger study sometime within the next academic year, with a far larger sample size.
“Our algorithm is machine-learning based, which means that the more examples of different bilirubin levels we have in our dataset, the better,” said Mariakakis. “Assuming that goes well, we would then start working with the FDA to figure out how to get their approval ― a process that the FDA is currently going through for the first time with some of our lab’s older projects.”
He emphasized that, when measuring bilirubin levels, the app uses jaundice as a marker. Although jaundice is is a symptom of pancreatic cancer, it is not pathognomonic for that disease.
“Jaundice also appears in people with hepatitis, Gilbert’s syndrome, and alcoholism,” explained Mariakakis. “We are particularly interested in pancreatic cancer because we have friends and family who have been affected by the disease, which is one of the reasons for that focus.”
The research was published in the Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies and will be presented September 13 at Ubicomp 2017, the Association for Computing Machinery’s International Joint Conference on Pervasive and Ubiquitous Computing.
Eyes as a Gateway
“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,” commented senior author Shwetak Patel, PhD, the Washington Research Foundation Entrepreneurship Endowed Professor in Computer Science and Engineering and Electrical Engineering, in a statement. “Our question was, Could we capture some of these changes that might lead to earlier detection with a selfie?”
The current gold standard for measuring bilirubin is with a blood test to assess total serum bilirubin (TSB) levels. Noninvasive methods of measuring bilirubin, such as use of a transcutaneous bilirubinometer (TcB), have been investigated. However, note the authors, the underlying computations for TcBs are designed for newborns and are not readily applicable to adults. This is partly due to the fact that normal concentrations of bilirubin are much higher in neonates, in whom jaundice is a fairly common occurrence in comparison with adults.
Earlier, the team at the Ubiquitous Computing Lab of the University of Washington developed a smartphone app called the BiliCam, which was designed to detect neonatal jaundice by taking pictures of the skin.