Artificial Intelligence in Colonoscopy: Where Are We Now in 2024?

IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Digestion Pub Date : 2025-02-13 DOI:10.1159/000544030
Wan Ying Lai, Kenneth Weicong Lin, Loi Pooi Ling, James W Li, Louis H S Lau, Philip W Y Chiu
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引用次数: 0

Abstract

Introduction: Colonoscopy has a crucial role in reducing colorectal cancer incidence and mortality. Different artificial intelligence (AI) systems were developed to further improve its quality assurance (computer-aided quality improvement [CAQ]), lesion detection (computer-aided detection [CADe]), and lesion characterization (computer-aided characterization [CADx]). There were studies investigating the roles of these AI systems in different domains of standard colonoscopies.

Methods: In this state-of-the-art narrative review, we summarize the current evidence, discuss existing limitations, as well as explore the future directions of AI in colonoscopy.

Results: CAQ enhances colonoscopy quality through real-time feedback and quality monitoring systems, but the studies have inconsistent results due to small training datasets and varied methodologies. CADe increases adenoma detection rate and reduces adenoma missed rates, but there are concerns about false positives, unnecessary polypectomies, potential deskilling of endoscopists, and cost-effectiveness. CADx systems have mixed results and accuracies in differentiating polyp types, and its use is further hindered by inadequate representation of sessile serrated lesions and a lack of rigorous trials comparing it with standard colonoscopy.

Conclusion: Despite the emerging evidence of AI-assisted colonoscopy, its potential drawbacks and limitations may hinder the further implementation in real-world clinical practice. Long-term data on clinical efficacy, cost-effectiveness, liability, and data sharing are the key areas to be addressed.

人工智能在结肠镜检查中的应用——2024年我们在哪里?
结肠镜检查在降低结直肠癌发病率和死亡率方面具有至关重要的作用。开发不同的人工智能(AI)系统,进一步提高其质量保证(计算机辅助质量改进,CAQ),病变检测(计算机辅助检测,CADe)和病变表征(计算机辅助表征,CADx)。有研究调查了这些人工智能系统在标准结肠镜检查的不同领域中的作用。方法:在这篇最新的叙述性综述中,我们总结了目前的证据,讨论了现有的局限性,并探讨了人工智能在结肠镜检查中的未来发展方向。结果:CAQ通过实时反馈和质量监测系统提高结肠镜检查质量,但由于训练数据集较小和方法不同,研究结果不一致。CADe提高了腺瘤的检出率,降低了腺瘤的漏检率,但也存在假阳性、不必要的息肉切除术、潜在的内窥镜医师技能下降和成本效益等问题。CADx系统在区分息肉类型方面的结果和准确性参差不齐,其使用进一步受阻于对无梗锯齿状病变的不充分代表,以及缺乏与标准结肠镜检查进行比较的严格试验。结论:尽管人工智能辅助结肠镜检查的证据越来越多,但其潜在的缺陷和局限性可能会阻碍其在实际临床实践中的进一步实施。关于临床疗效、成本效益、责任和数据共享的长期数据是需要解决的关键领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Digestion
Digestion 医学-胃肠肝病学
CiteScore
7.90
自引率
0.00%
发文量
39
审稿时长
6-12 weeks
期刊介绍: ''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.
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