ASGE Endoscopy Course at ACG: Everyday Endoscopy: Expertise Meets Evidence | October 2024-4_Varadarajulu Technology for Pancreaticobiliary Disease

4_Varadarajulu Technology for Pancreaticobiliary Disease

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The document explores the integration of artificial intelligence (AI) in diagnostics and treatment of pancreaticobiliary diseases, particularly focusing on bile duct procedures at ERCP and the assessment of pancreatic lesions via endoscopic ultrasound (EUS).<br /><br />### Applications of AI in Bile Duct and ERCP:<br />AI enhances the interpretation of medical imaging, predicts outcomes, and analyzes cholangioscopic images to facilitate more accurate diagnoses. This is crucial in determining stricture lengths during bile duct examinations. Technologies like digital single-operator cholangioscopy (SpyGlass DS) use AI to classify biliary strictures, with innovations like CNN-derived video analysis showing significant diagnostic accuracy improvements over traditional methods like brush cytology.<br /><br />A significant breakthrough includes combining clinical information with AI-enhanced cholangioscopy, achieving high sensitivity and specificity in distinguishing between benign and malignant biliary strictures. This technology promises improved prediction and treatment outcomes, addressing complexities typically involved with indeterminate biliary strictures.<br /><br />### Assessment of Pancreatic Lesions at EUS:<br />AI is also applied in the detection and quality improvement of pancreatic lesion assessments using EUS. The PANCRAIEUS software exemplifies advanced AI-driven real-time analysis. Studies indicate that AI enhances sensitivity and specificity in detecting different sized pancreatic masses, although there remain challenges in detecting smaller cystic lesions and differentiating between malignant and benign lesions.<br /><br />Clinical trials involving PANCRAIEUS reveal accuracies surpassing traditional methods in some areas, though further improvements are needed, specifically in the detection of small pancreatic cysts below 10 mm. The document outlines the need for ongoing development in real-time assessments with various EUS processors and echoendoscopes, emphasizing the potential of AI technology to vastly improve diagnostic accuracy and treatment outcomes in pancreaticobiliary conditions.

Keywords

artificial intelligence

pancreaticobiliary diseases

bile duct procedures

ERCP

endoscopic ultrasound

cholangioscopy

biliary strictures

PANCRAIEUS

diagnostic accuracy

treatment outcomes