Antonelli Giulio, Gkolfakis Paraskevas, Tziatzios Georgios, Papanikolaou Ioannis S, Triantafyllou Konstantinos, Hassan Cesare
Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome 00153, Italy.
Department of Gastroenterology Hepatopancreatology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels 1070, Belgium.
World J Gastroenterol. 2020 Dec 21;26(47):7436-7443. doi: 10.3748/wjg.v26.i47.7436.
Artificial intelligence (AI) systems, especially after the successful application of Convolutional Neural Networks, are revolutionizing modern medicine. Gastrointestinal Endoscopy has shown to be a fertile terrain for the development of AI systems aiming to aid endoscopists in various aspects of their daily activity. Lesion detection can be one of the two main aspects in which AI can increase diagnostic yield and abilities of endoscopists. In colonoscopy, it is well known that a substantial rate of missed neoplasia is still present, representing the major cause of interval cancer. In addition, an extremely high variability in adenoma detection rate, the main key quality indicator in colonoscopy, has been extensively reported. The other domain in which AI is believed to have a considerable impact on everyday clinical practice is lesion characterization and aid in "optical diagnosis". By predicting histology, such pathology costs may be averted by the implementation of two separate but synergistic strategies, namely the "leave-in-situ" strategy for < 5 mm hyperplastic lesions in the rectosigmoid tract, and "resect and discard" for the other diminutive lesions. In this opinion review we present current available evidence regarding the role of AI in improving lesions' detection and characterization during colonoscopy.
人工智能(AI)系统,尤其是在卷积神经网络成功应用之后,正在彻底改变现代医学。胃肠内镜检查已成为人工智能系统发展的一片沃土,这些系统旨在在内镜医师日常工作的各个方面提供帮助。病变检测可能是人工智能能够提高内镜医师诊断率和能力的两个主要方面之一。在结肠镜检查中,众所周知,仍有相当比例的肿瘤被漏诊,这是间期癌的主要原因。此外,作为结肠镜检查主要关键质量指标的腺瘤检出率存在极大差异,这一点已被广泛报道。人工智能被认为会对日常临床实践产生重大影响的另一个领域是病变特征描述及辅助“光学诊断”。通过预测组织学,可通过实施两种独立但相辅相成的策略来避免此类病理成本,即对于直肠乙状结肠段小于5毫米的增生性病变采用“原位保留”策略,对于其他微小病变采用“切除并丢弃”策略。在这篇观点综述中,我们展示了关于人工智能在提高结肠镜检查中病变检测和特征描述方面作用的现有证据。