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人工智能在结肠镜检查评估中的应用。

The use of artificial intelligence in colonoscopic evaluations.

作者信息

Khalaf Kareem, Rizkala Tommy, Repici Alessandro

机构信息

Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele.

出版信息

Curr Opin Gastroenterol. 2025 Jan 1;41(1):3-8. doi: 10.1097/MOG.0000000000001063. Epub 2024 Oct 25.

Abstract

PURPOSE OF REVIEW

This review aims to highlight the transformative impact of artificial intelligence in the field of gastrointestinal endoscopy, particularly in the detection and characterization of colorectal polyps.

RECENT FINDINGS

Over the past decade, artificial intelligence has significantly advanced the medical industry, including gastrointestinal endoscopy. Computer aided diagnosis - detection (CADe) systems have shown notable success in increasing ADR. Recent meta-analyses of RCTs have demonstrated that patients undergoing colonoscopy with CADe assistance had a higher ADR compared with conventional methods. Similarly, computer aided diagnosis - characterization (CADx) systems have proven effective in distinguishing between adenomatous and nonadenomatous polyps, enhancing diagnostic confidence and supporting cost-saving measures like the resect-and-discard strategy. Despite the high performance of these systems, the variability in real-world adoption highlights the importance of integrating artificial intelligence as an assistive tool rather than a replacement for human expertise.

SUMMARY

Artificial intelligence integration in colonoscopy, through CADe and CADx systems, marks a significant advancement in gastroenterology. These systems enhance lesion detection and characterization, leading to improved diagnostic accuracy, training outcomes, and clinical workflow efficiency. While artificial intelligence offers substantial benefits, the optimal approach involves using artificial intelligence to augment the expertise of endoscopists, ensuring that clinical decisions remain under human oversight.

摘要

综述目的

本综述旨在强调人工智能在胃肠内镜领域的变革性影响,特别是在结直肠息肉的检测和特征描述方面。

最新发现

在过去十年中,人工智能显著推动了包括胃肠内镜在内的医疗行业发展。计算机辅助诊断检测(CADe)系统在提高腺瘤检出率(ADR)方面取得了显著成功。最近对随机对照试验的荟萃分析表明,与传统方法相比,接受CADe辅助结肠镜检查的患者ADR更高。同样,计算机辅助诊断特征描述(CADx)系统已被证明在区分腺瘤性息肉和非腺瘤性息肉方面有效,增强了诊断信心,并支持诸如切除并丢弃策略等节省成本的措施。尽管这些系统性能很高,但实际应用中的差异凸显了将人工智能作为辅助工具而非替代人类专业知识的重要性。

总结

通过CADe和CADx系统将人工智能整合到结肠镜检查中,标志着胃肠病学的重大进步。这些系统增强了病变检测和特征描述,提高了诊断准确性、培训效果和临床工作流程效率。虽然人工智能带来了巨大益处,但最佳方法是利用人工智能增强内镜医师的专业知识,确保临床决策仍由人类监督。

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