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World J Gastroenterol. Aug 28, 2021; 27(32): 5351-5361
Published online Aug 28, 2021. doi: 10.3748/wjg.v27.i32.5351
Artificial intelligence application in diagnostic gastrointestinal endoscopy - Deus ex machina?
Fábio Pereira Correia, Luís Carvalho Lourenço
Fábio Pereira Correia, Luís Carvalho Lourenço, Department of Gastroenterology, Hospital Prof. Dr Fernando Fonseca, Lisbon 2720-276, Portugal
Author contributions: All authors contributed equally to this work, and have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicting interests
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Luís Carvalho Lourenço, MD, Attending Doctor, Department of Gastroenterology, Hospital Prof. Dr Fernando Fonseca, IC 19, Lisbon 2720-276, Portugal. luisclourenco@gmail.com
Received: January 28, 2021
Peer-review started: January 28, 2021
First decision: May 2, 2021
Revised: May 15, 2021
Accepted: July 19, 2021
Article in press: July 19, 2021
Published online: August 28, 2021
Abstract

The close relationship of medicine with technology and the particular interest in this symbiosis in recent years has led to the development of several computed artificial intelligence (AI) systems aimed at various areas of medicine. A number of studies have demonstrated that those systems allow accurate diagnoses with histological precision, thus facilitating decision-making by clinicians in real time. In the field of gastroenterology, AI has been applied in the diagnosis of pathologies of the entire digestive tract and their attached glands, and are increasingly accepted for the detection of colorectal polyps and confirming their histological classification. Studies have shown high accuracy, sensitivity, and specificity in relation to expert endoscopists, and mainly in relation to those with less experience. Other applications that are increasingly studied and with very promising results are the investigation of dysplasia in patients with Barrett's esophagus and the endoscopic and histological assessment of colon inflammation in patients with ulcerative colitis. In some cases AI is thus better than or at least equal to human abilities. However, additional studies are needed to reinforce the existing data, and mainly to determine the applicability of this technology in other indications. This review summarizes the state of the art of AI in gastroenterological pathology.

Keywords: Artificial intelligence, Computer-aided diagnosis, Deep learning, gastrointestinal endoscopy, Colorectal polyps, Dysplasia

Core Tip: The uses of artificial intelligence (AI) in gastroenterology are growing from day to day. Many published studies have demonstrated the potential benefits of using this technology in clinical practice. We review here the most recent studies related to the major hot topics of AI in gastroenterology, namely colorectal polyps, dysplasia in Barrett's esophagus, and inflammation in ulcerative colitis. The machine seems to cooperate with the human, helping him to exceed his abilities and making the future of this symbiosis very promising.