Multimodal artificial intelligence and large language models in gastrointestinal endoscopy: From lesion detection to workflow-integrated report generation

Figure 1 Levels of clinical integration of artificial intelligence in gastrointestinal endoscopy. A: Perception at the lesion level; B: Procedure-level understanding; C: Patient-level multimodal integration; D: Documentation and communication support. These levels are intended to represent the increasing clinical integration rather than a strict chronological sequence. This is an author-proposed conceptual framework intended for illustration and does not represent a validated clinical pathway or clinical guideline. AI: Artificial intelligence; CADe: Computer-aided detection; CADx: Computer-aided diagnosis; LLM: Large language model; BBPS: Boston Bowel Preparation Scale; EHR: Electronic health record; Hb: Hemoglobin; CRP: C-reactive protein; Alb: Albumin; ALT: Alanine aminotransferase.

Figure 2 Modality-specific encoding and task-oriented outputs in multimodal gastrointestinal endoscopic artificial intelligence. This framework does not imply that all modalities are available simultaneously or that all outputs are generated within a single final report. This is an author-proposed conceptual framework intended for illustration and does not represent a validated clinical pathway or clinical guideline. EHR: Electronic health record; BBPS: Boston Bowel Preparation Scale; MLP: Multilayer perceptron; Hb: Hemoglobin; CRP: C-reactive protein; Alb: Albumin; ALT: Alanine aminotransferase.

Figure 3 Artificial intelligence-assisted endoscopic documentation and report generation pathway. The figure illustrates a clinician-supervised documentation pathway rather than a fully automated real-time final reporting system. AI-generated draft reports and follow-up suggestions require clinician review before clinical use. Follow-up recommendations should be determined according to confirmed pathology, applicable clinical guidelines, and patient-specific factors. This is an author-proposed conceptual framework intended for illustration and does not represent a validated clinical pathway or clinical guideline.