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Endoscopic ultrasound artificial intelligence-assisted for prediction of gastrointestinal stromal tumors diagnosis:A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2023年第8期15卷 528-539页

作者： 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 Department of Gastroenterology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil Division of Hepatology and Endoscopy Department of GastroenterologyHarvard Medical SchoolBrigham and Women’s HospitalBostonMA 02115United States

BACKGROUND Subepithelial lesions(SELs)are gastrointestinal tumors with heterogeneous malignant *** ultrasonography(EUS)is the leading method for evaluation,but without histopathological analysis,precise differentiation of SEL risk is *** intelligence(AI)is a promising aid for the diagnosis of gastrointestinal lesions in the absence of *** To determine the diagnostic accuracy of AI-assisted EUS in diagnosing SELs,especially lesions originating from the muscularis propria *** Electronic databases including PubMed,EMBASE,and Cochrane Library were *** 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 *** reference standard was *** 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 *** sensitivity,specificity,positive,and negative predictive values were *** corresponding summary receiver operating characteristic curve and post-test probability were also *** Eight retrospective studies with a total of 2355 patients and 44154 images were included in this *** 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 *** diagnosis of GIST vs GIL by AI-assisted EUS,specificity was 90%(95%CI:0.88-0.95;P=0.02)and AUC of *** 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 vs GIL,the experts achieved a sensitivity of 73%(95%CI:0.65-0.80;P<0.01)and an AUC of ***

关键词： Subepithelial lesions Ultrasound endoscopy Artificial intelligence

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Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2019年第4期11卷 281-291页

作者： Fernanda P Logiudice Wanderlei M Bernardo Facundo Galetti Vitor M Sagae carolina O matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura Gastrointestinal Endoscopy Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de S?o Paulo Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Harvard Medical School

BACKGROUND For palliation of malignant biliary obstruction(MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography(ERCP)with the placement of metallic stents. Endoscopic ultrasound(EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP ***, however, there have been robust randomized clinical trials(RCTs)comparing EUS-guided drainage and ERCP as primary approaches to *** To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for *** This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment,Development and Evaluation *** The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients(112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96%n and 91.81%, respectively, with a risk difference(RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97; I^2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of-0.01%(95%CI:-0.12, 0.10; P = 0.90; I^2 =0%). The mean difference(MD) for the duration of the procedure was-0.12%(95%CI:-8.20, 7.97; P = 0.98; I^2 = 84%). In the EUS and ERCP groups, there were14 and 25 adverse events, respectively, with an RD of-0.06%(95%CI:-0.23, 0.12; P= 0.54; I^2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18; P =0.19; I^2 = 44%). The stent dysfunction rate was sig

关键词： Common bile duct neoplasms Endoscopic retrograde cholangiopancreatography Endosonography Ultrasonography Interventional/methods Endoscopic ultrasound Systematic review Meta-analysis

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