Kuwahara Takamichi, Hara Kazuo, Mizuno Nobumasa, Haba Shin, Okuno Nozomi, Fukui Toshitaka, Urata Minako, Yamamoto Yoshitaro
Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan.
DEN Open. 2023 Jun 30;4(1):e267. doi: 10.1002/deo2.267. eCollection 2024 Apr.
Pancreatic and biliary diseases encompass a range of conditions requiring accurate diagnosis for appropriate treatment strategies. This diagnosis relies heavily on imaging techniques like endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography. Artificial intelligence (AI), including machine learning and deep learning, is becoming integral in medical imaging and diagnostics, such as the detection of colorectal polyps. AI shows great potential in diagnosing pancreatobiliary diseases. Unlike machine learning, which requires feature extraction and selection, deep learning can utilize images directly as input. Accurate evaluation of AI performance is a complex task due to varied terminologies, evaluation methods, and development stages. Essential aspects of AI evaluation involve defining the AI's purpose, choosing appropriate gold standards, deciding on the validation phase, and selecting reliable validation methods. AI, particularly deep learning, is increasingly employed in endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography diagnostics, achieving high accuracy levels in detecting and classifying various pancreatobiliary diseases. The AI often performs better than doctors, even in tasks like differentiating benign from malignant pancreatic tumors, cysts, and subepithelial lesions, identifying gallbladder lesions, assessing endoscopic retrograde cholangiopancreatography difficulty, and evaluating the biliary strictures. The potential for AI in diagnosing pancreatobiliary diseases, especially where other modalities have limitations, is considerable. However, a crucial constraint is the need for extensive, high-quality annotated data for AI training. Future advances in AI, such as large language models, promise further applications in the medical field.
胰腺和胆道疾病包括一系列需要准确诊断以制定适当治疗策略的病症。这种诊断在很大程度上依赖于诸如内镜超声检查和内镜逆行胰胆管造影等成像技术。包括机器学习和深度学习在内的人工智能(AI)在医学成像和诊断中变得不可或缺,例如在结直肠息肉的检测方面。人工智能在诊断胰腺和胆道疾病方面显示出巨大潜力。与需要特征提取和选择的机器学习不同,深度学习可以直接将图像用作输入。由于术语、评估方法和发展阶段各不相同,准确评估人工智能的性能是一项复杂的任务。人工智能评估的基本方面包括确定人工智能的目的、选择合适的金标准、确定验证阶段以及选择可靠的验证方法。人工智能,尤其是深度学习,越来越多地应用于内镜超声检查和内镜逆行胰胆管造影诊断中,在检测和分类各种胰腺和胆道疾病方面达到了很高的准确率。即使在区分胰腺肿瘤、囊肿和上皮下病变的良恶性、识别胆囊病变、评估内镜逆行胰胆管造影的难度以及评估胆道狭窄等任务中,人工智能的表现通常也优于医生。人工智能在诊断胰腺和胆道疾病方面的潜力巨大,尤其是在其他方式存在局限性的情况下。然而,一个关键的限制因素是需要大量高质量的标注数据用于人工智能训练。人工智能的未来进展,如大语言模型,有望在医学领域得到进一步应用。
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