Harnessing artificial intelligence in gastrointestinal endoscopy for early detection of dysplastic lesions in inflammatory bowel disease

doi:10.4253/wjge.v18.i2.113912

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World Journal of Gastrointestinal Endoscopy

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World J Gastrointest Endosc. Feb 16, 2026; 18(2): 113912
Published online Feb 16, 2026. doi: 10.4253/wjge.v18.i2.113912

Harnessing artificial intelligence in gastrointestinal endoscopy for early detection of dysplastic lesions in inflammatory bowel disease

Dusan D Popovic, Milica Dragovic, Natasa Panic, Marija Marjanovic-Haljilji, Tijana Glisic, Snezana Lukic, Dragana Mijac, Jelena Bogdanovic, Ljiljana Bogdanović, Aleksandra Djokovic, Ana Starcevic, Branka Filipovic

Dusan D Popovic, Tijana Glisic, Snezana Lukic, Dragana Mijac, Jelena Bogdanovic, Ljiljana Bogdanović, Aleksandra Djokovic, Ana Starcevic, Branka Filipovic, Faculty of Medicine, University of Belgrade, Belgrade 11000, Beograd, Serbia

Dusan D Popovic, Milica Dragovic, Natasa Panic, Marija Marjanovic-Haljilji, Branka Filipovic, Department of Gastroenterology and Hepatology, Clinic for Internal Medicine, University Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Belgrade 11000, Beograd, Serbia

Tijana Glisic, Snezana Lukic, Dragana Mijac, Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, Belgrade 11000, Beograd, Serbia

Jelena Bogdanovic, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Beograd, Serbia

Ljiljana Bogdanović, Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade 11000, Beograd, Serbia

Aleksandra Djokovic, Department of Cardiology, Clinical and Hospital Center “Bezanijska Kosa”, Belgrade 11000, Beograd, Serbia

Ana Starcevic, Institute of Anatomy “Niko Miljanic”, Faculty of Medicine, University of Belgrade, Belgrade 11000, Beograd, Serbia

Author contributions: Popovic DD, Dragovic M, and Panic N contributed to the conceptualization and initial design of the manuscript; Popovic DD, Dragovic M, Panic N, Marjanovic-Haljilji M, Glisic T, Lukic S, and Mijac D were responsible for the literature search and data collection; Popovic DD, Dragovic M, Mijac D, Bogdanovic J, Bogdanovic L, Djokovic A, and Starcevic A critically analyzed and interpreted the reviewed studies; Popovic DD, Dragovic M, Panic N, Marjanovic-Haljilji M, Glisic T, Lukic S, Mijac D, Djokovic A, Starcevic A, and Filipovic B contributed to drafting and revising the manuscript for important intellectual content; Popovic DD and Filipovic B provided overall supervision, final revisions, and approval of the version to be submitted; and all authors have read and approved the final manuscript.

Supported by the Ministry of Science, Technological Development and Innovations, Republic of Serbia, No. 451-03-137/2025-03/200110.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest 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: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Dusan D Popovic, MD, PhD, Assistant Professor, Deputy Director, Faculty of Medicine, University of Belgrade, Dr. Subotica 8, Belgrade 11000, Beograd, Serbia. pduschan@gmail.com

Received: September 7, 2025
Revised: October 17, 2025
Accepted: December 12, 2025
Published online: February 16, 2026
Processing time: 151 Days and 3.4 Hours

Abstract

Artificial intelligence (AI) has become an increasingly valuable tool in gastrointestinal endoscopy, especially in the context of inflammatory bowel disease, including ulcerative colitis and Crohn’s disease. One of its most impactful applications is the early detection and accurate characterization of dysplastic lesions, which are often difficult to identify owing to chronic inflammation and mucosal alterations. AI-based systems, such as computer-aided detection and computer-aided diagnosis, have shown excellent performance in identifying subtle or flat lesions, improving the quality and consistency of dysplasia surveillance, and aiding in colorectal cancer prevention. In addition to neoplasia detection, AI plays a significant role in assessing mucosal inflammation and disease activity by offering objective scoring, reducing interobserver variability, and even predicting histological remission without the need for biopsy. These capabilities enhance decision-making and support a more personalized approach to patient management. While technical, regulatory, and integration challenges remain, current evidence supports the growing role of AI in improving both diagnostic precision and long-term outcomes in inflammatory bowel disease endoscopy.

Keywords: Artificial intelligence; Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Endoscopy; Dysplasia; Colorectal cancer surveillance; Computer-aided detection; Computer-aided diagnosis

Core Tip: This article highlights the evolving role of artificial intelligence in gastrointestinal endoscopy for patients with inflammatory bowel disease, emphasizing its potential to improve early dysplasia detection and strengthen colorectal cancer surveillance. Artificial intelligence-assisted systems enhance diagnostic accuracy, reduce interobserver variability, and support real-time clinical decision-making in the management of inflammatory bowel disease.