Artificial intelligence in colonoscopy: Enhancing quality indicators for optimal patient outcomes

Table 4 Summary of study characteristics evaluating artificial intelligence performance for invasion depth prediction and polyp characterization in colonoscopy

Ref.	Year	Study type	Image type	AI algorithm	Patient number training set	Patient number validation set	Patient number testing set	Primary outcome	Sensitivity (%)	Specificity (%)	Accuracy (%)
Luo et al[69]	2021	Single center retrospective	WLI	Deep learning	556		137	Invasion depth Tis/T1a vs T1b/> T2	91.2	91	91.1
Minami et al[70]	2022	Single center retrospective	WLI, NBI, CCE	Deep learning	91	49	56	Submucosal invasion depth SM1 vs SM2/3	87.2	35.7	74.4
Lu et al[68]	2022	Multicenter retrospective	WLI, NBI, BLI	Deep learning	305		140	Invasion depth LGD/HGD/IM/SM1 vs SM2/advanced CRC	90.0	94.2	93.8
Nemoto et al[72]	2023	Multicenter retrospective	WLI	Deep learning	1084		400	Invasion depth Tis/T1a vs T1b	59.8	94.4	87.3
Tokunaga et al[73]1	2021	Single center retrospective	WLI	Deep learning	824		211	Invasion depth LGD/HGD/SM1 vs SM2/advanced CRC	96.7	75.0	90.3
Nakajima et al[71]	2022	Multicenter retrospective	WLI	Deep learning	313		44	Invasion depth Tis/T1a vs T1b	81.0	87.0	84.0
Song et al[75]	2020	Single center retrospective	NBI	Deep learning	624		545	Invasion depth SSP/BA/SM1 vs SM2/3	58.8	93.3	81.3
Lui et al[74]	2019	Single center retrospective	WLI, NBI	Deep learning	1652		76	Invasion depth polyps ≥ 2 cm adenoma/SM1 vs SM2	94.6	92.3	94.3
Yao et al[76]	2023	Multicenter retrospective	WLI, IEE	Deep learning	339		198	Invasion depth large SSPs ≥ 10 mm	78.8	96.2	90.4
Racz et al[66]	2022	Single center retrospective	NBI	Machine learning	279			Polyp characterization non-neoplastic vs neoplastic2	92.2	77.6	86.6
Ham et al[67]	2025	Single center retrospective	WLI	Deep learning	2696		476	Polyp characterization low vs high-risk adenomas ≤ 10 mm3	75.6	95.7	93.8

¹Clinical impact data were only explicitly reported in the study, which demonstrated a 24% reduction in unnecessary resections. Other included studies did not provide quantifiable real-world outcome metrics.

²Non-neoplastic polyps were defined as hyperplastic polyps, whereas neoplastic polyps included tubular adenomas, villous adenomas, and sessile serrated lesions.

³High-risk adenomas were defined as high-grade dysplasia or adenomas with villous histology.

AI: Artificial intelligence; WLI: White light imaging; NBI: Narrow band imaging; CCE: Conventional chromoendoscopy; BLI: Blue light imaging; IEE: Image enhanced endoscopy; SM: Submucosal invasion; LGD: Low-grade dysplasia; HGD: High-grade dysplasia; IM: Intramucosal carcinoma; CRC: Colorectal cancer; SSP: Sessile serrated polyp; BA: Benign conventional adenoma.