Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Artif Intell Gastrointest Endosc. Jan 6, 2023; 4(1): 1-11
Published online Jan 6, 2023. doi: 10.37126/aige.v4.i1.1
Kyoto classification of gastritis, virtual chromoendoscopy and artificial intelligence: Where are we going? What do we need?
Alba Panarese, Yutaka Saito, Rocco Maurizio Zagari
Alba Panarese, Division of Gastroenterology and Digestive Endoscopy, Department of Medical Sciences, Central Hospital - Azienda Ospedaliera, Taranto 74123, Italy
Yutaka Saito, Division of Endoscopy, National Cancer Center Hospital, Tokyo 104-0045, Japan
Rocco Maurizio Zagari, Gastroenterology Unit and Department of Surgical and Medical Sciences, IRCCS Azienda Ospedaliero-Universitaria and University of Bologna, Bologna 40121, Italy
Author contributions: Panarese A conceived and wrote the manuscript, reviewed and analyzed the literature; Panarese A and Zagari RM edited the manuscript; all the authors revised and approved the final article.
Conflict-of-interest statement: All the authors declare no conflict of interests for this article.
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:
Corresponding author: Alba Panarese, MD, Chief Physician, Director, Division of Gastroenterology and Digestive Endoscopy, Department of Medical Sciences, Central Hospital - Azienda Ospedaliera, Francesco Bruno Street, 1, Taranto 74123, Italy.
Received: September 14, 2022
Peer-review started: September 14, 2022
First decision: September 29, 2022
Revised: October 18, 2022
Accepted: January 3, 2023
Article in press: January 3, 2023
Published online: January 6, 2023

Chronic gastritis (CG) is a widespread and frequent disease, mainly caused by Helicobacter pylori infection, which is associated with an increased risk of gastric cancer. Virtual chromoendoscopy improves the endoscopic diagnostic efficacy, which is essential to establish the most appropriate therapy and to enable cancer prevention. Artificial intelligence provides algorithms for the diagnosis of gastritis and, in particular, early gastric cancer, but it is not yet used in practice. Thus, technological innovation, through image resolution and processing, optimizes the diagnosis and management of CG and gastric cancer. The endoscopic Kyoto classification of gastritis improves the diagnosis and management of this disease, but through the analysis of the most recent literature, new algorithms can be proposed.

Keywords: Early gastric cancer, Artificial intelligence, Helicobacter pylori, Dysplasia, Image enhanced endoscopy, Kyoto classification of gastritis

Core Tip: Advances in virtual chromoendoscopy have improved the knowledge and management of chronic gastritis and led to the Kyoto classification. Artificial intelligence promotes progression in the management of gastric cancer and the diffusion of innovation, allowing new diagnostic algorithms that include both active inflammation and dysplasia as evolutionary steps towards cancer.