Background and Aims
Artificial intelligence (AI), specifically deep learning, offers the potential to
enhance the field of GI endoscopy in areas ranging from lesion detection and classification
to quality metrics and documentation. Progress in this field will be measured by whether
AI implementation can lead to improved patient outcomes and more efficient clinical
workflow for GI endoscopists. The aims of this article are to report the findings
of a multidisciplinary group of experts focusing on issues in AI research and applications
related to gastroenterology and endoscopy, to review the current status of the field,
and to produce recommendations for investigators developing and studying new AI technologies
for gastroenterology.
Methods
A multidisciplinary meeting was held on September 28, 2019, bringing together academic,
industry, and regulatory experts in diverse fields including gastroenterology, computer
and imaging sciences, machine learning, computer vision, U.S. Food and Drug Administration,
and the National Institutes of Health. Recent and ongoing studies in gastroenterology
and current technology in AI were presented and discussed, key gaps in knowledge were
identified, and recommendations were made for research that would have the highest
impact in making advances and implementation in the field of AI to gastroenterology.
Results
There was a consensus that AI will transform the field of gastroenterology, particularly
endoscopy and image interpretation. Powered by advanced machine learning algorithms,
the use of computer vision in endoscopy has the potential to result in better prediction
and treatment outcomes for patients with gastroenterology disorders and cancer. Large
libraries of endoscopic images, “EndoNet,” will be important to facilitate development
and application of AI systems. The regulatory environment for implementation of AI
systems is evolving, but common outcomes such as colon polyp detection have been highlighted
as potential clinical trial endpoints. Other threshold outcomes will be important,
as well as clarity on iterative improvement of clinical systems.
Conclusions
Gastroenterology is a prime candidate for early adoption of AI. AI is rapidly moving
from an experimental phase to a clinical implementation phase in gastroenterology.
It is anticipated that the implementation of AI in gastroenterology over the next
decade will have a significant and positive impact on patient care and clinical workflows.
Ongoing collaboration among gastroenterologists, industry experts, and regulatory
agencies will be important to ensure that progress is rapid and clinically meaningful.
However, several constraints and areas will benefit from further exploration, including
potential clinical applications, implementation, structure and governance, role of
gastroenterologists, and potential impact of AI in gastroenterology.
Abbreviations:
ADR (adenoma detection rate), AI (artificial intelligence), CAD (computer-aided diagnosis), FDA (U.S. Food and Drug Administration)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 25, 2020
Accepted:
April 16,
2020
Received:
February 29,
2020
Footnotes
DISCLOSURE: The following authors disclosed financial relationships: M. Wallace: Consultant for Virgo Inc, Cosmo/Aries Pharmaceuticals, Anx Robotica, Covidien, GI Supply, Boston Scientific, Endokey, Endostart, and Microtek; stock in Virgo Inc; research grants from Cosmo/Aries Pharmaceuticals, Fujifilm, Boston Scientific, Olympus, Medtronic, and Ninepoint Medical; other compensation from Synergy Pharmaceuticals and Cook Medical. T. Berzin: Consultant for Wilson AI, Fujifilm, and Medtronic. M. Byrne: Chief executive officer for Satisfai Health; co-development agreement with Olympus in AI and colon polyps with Ai4gi. H. Celik, S. Gross: Consultant for Olympus. Y. Mori: Consultant and speaker for Olympus. A. Ninh: Financial and equity in and cofounder and chief executive officer for Docbot Inc. A. Repici: Consultant for Boston Scientific and Medtronic; research grant from Fujifilm. D. Rex: Consultant for Olympus, Boston Scientific, Covidien/Medtronic, Aries Pharmaceutical, Braintree Laboratories, Lumendl, Ltd, Norgine, Endokey, and GI Supply; research grants from Olympus, Endoaid, Medivators, and Eribe USA Inc; ownership in Satisfai Health. S.J. Thakkar: Consultant for Olympus and Boston Scientific. J. E. van Hooft: Consultant for Cook Medical, Boston Scientific, and Medtronic; research grants from Cook Medical and Abbott. P. Sharma: Consultant for Olympus and Boston Scientific; research grants from Cosmo Pharmaceuticals, CDx Laboratories, Erbe, Fujifilm, Medtronic, and US Endoscopy. All other authors disclosed no financial relationships.
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© 2020 by the American Society for Gastrointestinal Endoscopy
