| 13 | Endoscopic ultrasound artificial intelligence-assisted for prediction of gastrointestinal stromal tumors diagnosis:A systematic review and meta-analysis显示文摘BACKGROUND Subepithelial lesions(SELs)are gastrointestinal tumors with heterogeneous malignant potential.Endoscopic ultrasonography(EUS)is the leading method for evaluation,but without histopathological analysis,precise differentiation of SEL risk is limited.Artificial intelligence(AI)is a promising aid for the diagnosis of gastrointestinal lesions in the absence of histopathology.AIM To determine the diagnostic accuracy of AI-assisted EUS in diagnosing SELs,especially lesions originating from the muscularis propria layer.METHODS Electronic databases including PubMed,EMBASE,and Cochrane Library were searched.Patients of any sex and>18 years,with SELs assessed by EUS AIassisted,with previous histopathological diagnosis,and presented sufficient data values which were extracted to construct a 2×2 table.The reference standard was histopathology.The primary outcome was the accuracy of AI for gastrointestinal stromal tumor(GIST).Secondary outcomes were AI-assisted EUS diagnosis for GIST vs gastrointestinal leiomyoma(GIL),the diagnostic performance of experienced endoscopists for GIST,and GIST vs GIL.Pooled sensitivity,specificity,positive,and negative predictive values were calculated.The corresponding summary receiver operating characteristic curve and post-test probability were also analyzed.RESULTS Eight retrospective studies with a total of 2355 patients and 44154 images were included in this meta-analysis.The AI-assisted EUS for GIST diagnosis showed a sensitivity of 92%[95%confidence interval(CI):0.89-0.95;P<0.01),specificity of 80%(95%CI:0.75-0.85;P<0.01),and area under the curve(AUC)of 0.949.For diagnosis of GIST vs GIL by AI-assisted EUS,specificity was 90%(95%CI:0.88-0.95;P=0.02)and AUC of 0.966.The experienced endoscopists’values were sensitivity of 72%(95%CI:0.67-0.76;P<0.01),specificity of 70%(95%CI:0.64-0.76;P<0.01),and AUC of 0.777 for GIST.Evaluating GIST vs GIL,the experts achieved a sensitivity of 73%(95%CI:0.65-0.80;P<0.01)and an AUC of 0.819.CONCLUSION AI-assisted EUS has high diagnostic accuracy for fourth-layer SELs,especially for GIST,demonstrating superiority compared to experienced endoscopists’and improving their diagnostic performance in the absence of invasive procedures. | Rômulo Sérgio Araújo Gomes Guilherme Henrique Peixoto de Oliveira Diogo Turiani Hourneaux de Moura Ana Paula Samy Tanaka Kotinda Carolina Ogawa Matsubayashi Bruno Salomão Hirsch Matheus de Oliveira Veras João Guilherme Ribeiro Jordão Sasso Roberto Paolo Trasolini Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura | 2023 | World Journal of Gastrointestinal Endoscopy2023，15，8： | 0 |
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