Objectives: Gastrointestinal stromal tumors (GISTs) are thought to have a malignant potential. However, utilizing endoscopic ultrasound (EUS) to differentiate GISTs from other types of subepithelial lesions (SELs) remains challenging. Artificial intelligence (AI)-based diagnostic systems for EUS have been reported to have a promising performance, although the results of the previous studies remain controversial. In this meta-analysis, we aimed to assess the diagnostic accuracy of AI-based EUS in distinguishing GISTs from other SELs.Methods: A literature search was conducted on MEDLINE and EMBASE databases to identify relevant articles. The sensitivity, specificity, and area under the summary receiver operating characteristic curve (AUROC) of eligible studies were analyzed.Results: Seven studies were eligible for the final analysis. The combined sensitivity and specificity of AI-based EUS were 0.93 (95% confidence interval [CI] 0.88-0.96) and 0.78 (95% CI 0.67-0.87), respectively. The overall diagnostic odds ratio of AI-based EUS for GISTs was ) with an AUROC of 0.94.Conclusions: AI-based EUS showed high diagnostic ability and might help better differentiate GISTs from other SELs. More prospective studies on the diagnosis of GISTs using AI-based EUS are warranted in clinical setting.

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