Automatic Identification of Papillary Projections in Indeterminate Biliary Strictures Using Digital Single-Operator Cholangioscopy

Ribeiro, Tiago; Saraiva, Miguel Mascarenhas; Afonso, João; Ferreira, João; Vilas-Boas, Filipe; Parente, Marco; Jorge, Renato Natal; Pereira, Pedro; Macedo, Guilherme

doi:10.14309/ctg.0000000000000418

Cited by 9 publications

(2 citation statements)

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“…There was a low risk of bias regarding the selection of patients, index test and reference standards; however, the 4 studies involving cholangioscopy did not clearly account for risk of bias in the flow and timing of the study. There were patient selection applicability concerns in the study by Reibero et al and index test applicability concerns in the study by Yao et al , notably due to variable index definitions [ 20 , 21 ].…”

Section: Resultsmentioning

confidence: 99%

Artificial intelligence in endoscopic imaging for detection of malignant biliary strictures and cholangiocarcinoma: a systematic review

Njei¹

2023

aog

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Background Artificial intelligence (AI), when applied to computer vision using a convolutional neural network (CNN), is a promising tool in “difficult-to-diagnose” conditions such as malignant biliary strictures and cholangiocarcinoma (CCA). The aim of this systematic review is to summarize and review the available data on the diagnostic utility of endoscopic AI-based imaging for malignant biliary strictures and CCA. Methods In this systematic review, PubMed, Scopus and Web of Science databases were reviewed for studies published from January 2000 to June 2022. Extracted data included type of endoscopic imaging modality, AI classifiers, and performance measures. Results The search yielded 5 studies involving 1465 patients. Of the 5 included studies, 4 (n=934; 3,775,819 images) used CNN in combination with cholangioscopy, while one study (n=531; 13,210 images) used CNN with endoscopic ultrasound (EUS). The average image processing speed of CNN with cholangioscopy was 7-15 msec per frame while that of CNN with EUS was 200-300 msec per frame. The highest performance metrics were observed with CNN-cholangioscopy (accuracy 94.9%, sensitivity 94.7%, and specificity 92.1%). CNN-EUS was associated with the greatest clinical performance application, providing station recognition and bile duct segmentation; thus reducing procedure length and providing real-time feedback to the endoscopist. Conclusions Our results suggest that there is increasing evidence to support a role for AI in the diagnosis of malignant biliary strictures and CCA. CNN-based machine leaning of cholangioscopy images appears to be the most promising, while CNN-EUS has the best clinical performance application.

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Section: Resultsmentioning

confidence: 99%

Artificial intelligence in endoscopic imaging for detection of malignant biliary strictures and cholangiocarcinoma: a systematic review

Njei¹

2023

aog

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“…Cytology of aspiration fluid from the irrigation performed during cholangioscopy and cholangioscopy guided biopsies significantly improves the sensitivity for detecting malignancy [38]. Future development of AI tools may optimize the macroscopic characterization of biliary strictures [39][40][41].…”

Section: Indeterminate Biliary Stricture and Biliary Tract Neoplasiamentioning

confidence: 99%

Cholangioscopy for biliary diseases

Becq

Soualy

Camus

2023

Current Opinion in Gastroenterology

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Purpose of reviewCholangioscopy is a mini-invasive endoscopic procedure, which consists in a direct intraductal visualization of the biliary tract. The purpose of this review is to summarize the technique, the clinical applications, as well as future perspectives of cholangioscopy. Recent findingsNumerous technologic advances during the last decades have allowed for an improved utility and functionality, leading to a broader use of this procedure, for diagnostic or therapeutic purposes, in the setting of biliary diseases. Novel tools and emerging indications have been developed and more are yet to come. SummaryCholangioscopy can be performed by peroral, percutaneous transhepatic or intra-operative transcystic or transcholedochal access. Clinical applications of cholangioscopy are multiple, ranging from visual impression and optical guided biopsies of indeterminate biliary strictures to the management of difficult stones , guidance before biliary stenting and retrieval of migrated ductal stents. Multiple devices such as lithotripsy probes, biopsy forceps, snares and baskets have been developed to help achieve these procedures successfully. Cholangioscopy has improved the way biliary diseases can be visualized and treated. New technology, accessories, and applications are expected in the future.

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