Application of artificial intelligence in the diagnosis and treatment of hepatocellular carcinoma: A review

Abstract

Although artificial intelligence (AI) was initially developed many years ago, it has experienced spectacular advances over the last 10 years for application in the field of medicine, and is now used for diagnostic, therapeutic and prognostic purposes in almost all fields. Its application in the area of hepatology is especially relevant for the study of hepatocellular carcinoma (HCC), as this is a very common tumor, with particular radiological characteristics that allow its diagnosis without the need for a histological study. However, the interpretation and analysis of the resulting images is not always easy, in addition to which the images vary during the course of the disease, and prognosis and treatment response can be conditioned by multiple factors. The vast amount of data available lend themselves to study and analysis by AI in its various branches, such as deep-learning (DL) and machine learning (ML), which play a fundamental role in decision-making as well as overcoming the constraints involved in human evaluation. ML is a form of AI based on automated learning from a set of previously provided data and training in algorithms to organize and recognize patterns. DL is a more extensive form of learning that attempts to simulate the working of the human brain, using a lot more data and more complex algorithms. This review specifies the type of AI used by the various authors. However, well-designed prospective studies are needed in order to avoid as far as possible any bias that may later affect the interpretability of the images and thereby limit the acceptance and application of these models in clinical practice. In addition, professionals now need to understand the true usefulness of these techniques, as well as their associated strengths and limitations.

Keywords: Artificial intelligence; Machine learning; Hepatocellular carcinoma; Diagnosis; Treatment; Prognosis

Core Tip: The biological variability in the behavior of hepatocellular carcinoma (HCC), conditioned by multiple factors, makes it difficult to establish general standards of action applicable equally to all patients. Analysis of the vast amount of data now available and their relation with tumor behavior is fundamental to be able to establish an efficient approach to HCC. It is here that the computational power of artificial intelligence can play a determining role, though it is necessary to understand the strengths and limitations of this technology before it can be applied in clinical practice.