Artificial intelligence in gastroenterology: Where are we heading?

Glenn Koleth; James Emmanue; Marco Spadaccini; Pietro Mascagni; Kareem Khalaf; Yuichi Mori; Giulio Antonelli; Roberta Maselli; Silvia Carrara; Piera Alessia Galtieri; Gaia Pellegatta; Alessandro Fugazza; Andrea Anderloni; Carmelo Selvaggio; Michael Bretthauer; Alessio Aghemo; Antonino Spinelli; Victor Savevski; Prateek Sharma; Cesare Hassan; Alessandro Repici

doi:10.1055/a-1907-6569

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(11): E1474-E1480
DOI: 10.1055/a-1907-6569

Original article

Artificial intelligence in gastroenterology: Where are we heading?

Glenn Koleth‡

¹Hospital Selayang, Department of Gastroenterology and Hepatology, Selangor, Malaysia

,

James Emmanue‡

¹Hospital Selayang, Department of Gastroenterology and Hepatology, Selangor, Malaysia

²Queen Elizabeth Hospital, Department of Gastroenterology and Hepatology, Sabah, Malaysia

,

Marco Spadaccini

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Pietro Mascagni

⁵Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

⁶Institute of Image-Guided Surgery, IHU-Strasbourg, France

,

Kareem Khalaf

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Yuichi Mori

⁷Clinical Effectiveness Research Group, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway

⁸Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Giulio Antonelli

⁹"Sapienza" University of Rome, Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Rome, Italy

¹⁰Ospedale dei Castelli Hospital, Gastroenterology and Digestive Endoscopy Unit, Ariccia, Rome, Italy

,

Roberta Maselli

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Silvia Carrara

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Piera Alessia Galtieri

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Gaia Pellegatta

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Alessandro Fugazza

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Andrea Anderloni

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Carmelo Selvaggio

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

,

Michael Bretthauer

⁷Clinical Effectiveness Research Group, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway

,

Alessio Aghemo

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

¹¹Humanitas Research Hospital – IRCCS, Internal Medicine and Hepatology Unit, Rozzano, Italy

,

Antonino Spinelli

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

¹²Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Division of Colon and Rectal Surgery, Humanitas Clinical and Research Hospital IRCCS, Rozzano, Milan, Italy

,

Victor Savevski

¹³Humanitas Clinical and Research Center – IRCCS, Artificial Intelligence Research, Rozzano, Italy

,

Prateek Sharma

¹⁴Kansas City VA Medical Center, Gastroenterology and Hepatology, Kansas City, United States

,

Cesare Hassan^**

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

,

Alessandro Repici^**

³Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy

⁴Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Rozzano, Italy

› Author Affiliations

Abstract

Background and study aims Artificial intelligence (AI) is set to impact several fields within gastroenterology. In gastrointestinal endoscopy, AI-based tools have translated into clinical practice faster than expected. We aimed to evaluate the status of research for AI in gastroenterology while predicting its future applications.

Methods All studies registered on Clinicaltrials.gov up to November 2021 were analyzed. The studies included used AI in gastrointestinal endoscopy, inflammatory bowel disease (IBD), hepatology, and pancreatobiliary diseases. Data regarding the study field, methodology, endpoints, and publication status were retrieved, pooled, and analyzed to observe underlying temporal and geographical trends.

Results Of the 103 study entries retrieved according to our inclusion/exclusion criteria, 76 (74 %) were based on AI application to gastrointestinal endoscopy, mainly for detection and characterization of colorectal neoplasia (52/103, 50 %). Image analysis was also more frequently reported than data analysis for pancreaticobiliary (six of 10 [60 %]), liver diseases (eight of nine [89 %]), and IBD (six of eight [75 %]). Overall, 48 of 103 study entries (47 %) were interventional and 55 (53 %) observational. In 2018, one of eight studies (12.5 %) were interventional, while in 2021, 21 of 34 (61.8 %) were interventional, with an inverse ratio between observational and interventional studies during the study period. The majority of the studies were planned as single-center (74 of 103 [72 %]) and more were in Asia (45 of 103 [44 %]) and Europe (44 of 103 [43 %]).

Conclusions AI implementation in gastroenterology is dominated by computer-aided detection and characterization of colorectal neoplasia. The timeframe for translational research is characterized by a swift conversion of observational into interventional studies.

Full Text

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Supplementary Material

Supplementary material