Artificial intelligence in gastroenterology: A state-of-the-art review

Abstract

The development of artificial intelligence (AI) has increased dramatically in the last 20 years, with clinical applications progressively being explored for most of the medical specialties. The field of gastroenterology and hepatology, substantially reliant on vast amounts of imaging studies, is not an exception. The clinical applications of AI systems in this field include the identification of premalignant or malignant lesions (e.g., identification of dysplasia or esophageal adenocarcinoma in Barrett’s esophagus, pancreatic malignancies), detection of lesions (e.g., polyp identification and classification, small-bowel bleeding lesion on capsule endoscopy, pancreatic cystic lesions), development of objective scoring systems for risk stratification, predicting disease prognosis or treatment response [e.g., determining survival in patients post-resection of hepatocellular carcinoma), determining which patients with inflammatory bowel disease (IBD) will benefit from biologic therapy], or evaluation of metrics such as bowel preparation score or quality of endoscopic examination. The objective of this comprehensive review is to analyze the available AI-related studies pertaining to the entirety of the gastrointestinal tract, including the upper, middle and lower tracts; IBD; the hepatobiliary system; and the pancreas, discussing the findings and clinical applications, as well as outlining the current limitations and future directions in this field.

Keywords: Artificial intelligence; Machine learning; Deep learning; Clinical applications; Gastroenterology

Core Tip: Artificial intelligence (AI) clinical applications in gastroenterology and hepatology, which heavily relies on imaging, have dramatically expanded in the last 20 years. These applications include the detection of lesions, identification of premalignant or malignant lesions, development of objective scoring systems for risk stratification, predicting disease prognosis or treatment response, or evaluation of metrics such as bowel preparation score or quality of endoscopic examination. The objective of this review is to pool the available AI-related studies pertaining to the entire gastrointestinal tract, discussing findings and clinical applications, as well as outlining the current limitations and future directions in this field.