Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Dig Dis. 2022;40(4):395-408. doi: 10.1159/000518232. Epub 2021 Jul 21.
Over the past decade, several artificial intelligence (AI) systems are developed to assist in endoscopic assessment of (pre-)cancerous lesions of the gastrointestinal (GI) tract. In this review, we aimed to provide an overview of the possible indications of AI technology in upper GI endoscopy and hypothesize about potential challenges for its use in clinical practice.
Application of AI in upper GI endoscopy has been investigated for several indications: (1) detection, characterization, and delineation of esophageal and gastric cancer (GC) and their premalignant conditions; (2) prediction of tumor invasion; and (3) detection of Helicobacter pylori. AI systems show promising results with an accuracy of up to 99% for the detection of superficial and advanced upper GI cancers. AI outperformed trainee and experienced endoscopists for the detection of esophageal lesions and atrophic gastritis. For GC, AI outperformed mid-level and trainee endoscopists but not expert endoscopists.
Application of artificial intelligence (AI) in upper gastrointestinal endoscopy may improve early diagnosis of esophageal and gastric cancer and may enable endoscopists to better identify patients eligible for endoscopic resection. The benefit of AI on the quality of upper endoscopy still needs to be demonstrated, while prospective trials are needed to confirm accuracy and feasibility during real-time daily endoscopy.
在过去的十年中，已经开发出了几种人工智能 (AI) 系统，以协助评估胃肠道 (GI) 道的（前）癌性病变。在这篇综述中，我们旨在概述 AI 技术在上 GI 内镜检查中的可能应用，并推测其在临床实践中的应用可能面临的挑战。
已经针对以下几个上 GI 内镜的适应证对 AI 的应用进行了研究：(1) 检测、特征描述和勾画食管和胃癌 (GC) 及其癌前病变；(2) 预测肿瘤浸润；以及 (3) 检测幽门螺杆菌。AI 系统在检测上 GI 浅层和晚期癌症方面表现出了高达 99%的准确率。AI 在检测食管病变和萎缩性胃炎方面优于受训者和有经验的内镜医生。对于 GC，AI 优于中级和受训内镜医生，但不如专家内镜医生。
在上 GI 内镜中应用人工智能 (AI) 可能有助于提高食管和胃癌的早期诊断，并使内镜医生能够更好地识别有资格进行内镜下切除的患者。AI 对提高上内镜质量的益处仍需进一步证明，而前瞻性试验则需要在实时日常内镜检查中确认其准确性和可行性。
