Artificial Intelligence-assisted colonoscopy and colorectal cancer screening: Where are we going?

Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
Published Date:

Abstract

Colorectal cancer is a significant global health concern, necessitating effective screening strategies to reduce its incidence and mortality rates. Colonoscopy plays a crucial role in the detection and removal of colorectal neoplastic precursors. However, there are limitations and variations in the performance of endoscopists, leading to missed lesions and suboptimal outcomes. The emergence of artificial intelligence (AI) in endoscopy offers promising opportunities to improve the quality and efficacy of screening colonoscopies. In particular, AI applications, including computer-aided detection (CADe) and computer-aided characterization (CADx), have demonstrated the potential to enhance adenoma detection and optical diagnosis accuracy. Additionally, AI-assisted quality control systems aim to standardize the endoscopic examination process. This narrative review provides an overview of AI principles and discusses the current knowledge on AI-assisted endoscopy in the context of screening colonoscopies. It highlights the significant role of AI in improving lesion detection, characterization, and quality assurance during colonoscopy. However, further well-designed studies are needed to validate the clinical impact and cost-effectiveness of AI-assisted colonoscopy before its widespread implementation.

Authors

  • Marco Spadaccini
    Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
  • Joel Troya
    Department of Internal Medicine II, Interventional and Experimental Endoscopy (InExEn), University Hospital Wuerzburg, Würzburg, Germany.
  • Kareem Khalaf
    The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto, Toronto, Canada.
  • Antonio Facciorusso
    Department of Medical Sciences, Section of Gastroenterology, University of Foggia, Foggia, Italy.
  • Roberta Maselli
    Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
  • Alexander Hann
    Department of Internal Medicine II, Interventional and Experimental Endoscopy (InExEn), University Hospital Wuerzburg, Würzburg, Germany.
  • Alessandro Repici
    Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano, 20089, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.