To the Editor:Gastroscopy is considered to be the main method for diagnosing gastric lesions.[1]But correctly diagnosing different gastric lesions under white light endoscopy(WLE)may be challenging as the morphologica...To the Editor:Gastroscopy is considered to be the main method for diagnosing gastric lesions.[1]But correctly diagnosing different gastric lesions under white light endoscopy(WLE)may be challenging as the morphological manifestations of gastric lesions are varied and some are even subtle.Due to the uneven diagnostic levels across various regions and the scarcity of experienced endoscopists,misdiagnosis and missed diagnosis may occur.In addition,endoscopists are overwhelmed by heavy workloads,and fatigue may lead to a further decline in diagnostic performance,even for experienced endoscopists.展开更多
Endoscopic remission is the primary long-term therapeutic goal in inflammatory bowel disease(IBD).The assessment of this therapeutic target typically relies on white light endoscopy(WLE)combined with histological samp...Endoscopic remission is the primary long-term therapeutic goal in inflammatory bowel disease(IBD).The assessment of this therapeutic target typically relies on white light endoscopy(WLE)combined with histological sampling.Nonetheless,distinguishing between endoscopic mild,patchy inflammation and quiescent disease can be challenging,and discrepancies have been observed between endoscopic and histological disease activity,mainly when using WLE.Recent advances in endoscopic technologies are gradually transforming clinical practice.Dye-based chromoendoscopy and virtual chromoendoscopy are currently available in the endoscopist armamentarium,enhancing the assessment of mucosal architecture and vascular patterns,improving the visualisation of patchy inflammation and helping detect subtle dysplastic colonic lesions.Moreover,novel advanced tools,including probe-based confocal laser endomicroscopy and endocytoscopy,offer the remarkable ability to investigate the deep aspect of the gastrointestinal tract in real time,including the structure and function of the intestinal barrier and inflammatory-related alterations.Thus,these techniques can bridge the gap between endoscopy and histology,enabling the integration of novel treat-to-target strategies associated with more favourable outcomes.Artificial intelligence(AI)represents a further step forward in overcoming the limitations associated with endoscopy,including subjectivity and the requirement for expertise.Their implementation in clinical practice may enable standardised,accurate and rapid disease assessment.Moreover,AI can aid in accurately predicting responses to therapy and disease outcomes by stratifying patients’risks,thereby advancing us towards patient-centred personalised medicine.This narrative review summarises the available advanced endoscopic technologies and their integration with AI to assess IBD activity,define promising therapeutic targets and predict long-term outcomes.展开更多
基金supported by grants from 1·3·5 project for Artificial Intelligence,West China Hospital,Sichuan University(No.ZYAI24006)Cadres Health Research Project of Sichuan Province(No.ZH2024-102)+2 种基金National Natural Science Foundation of China(No.62376169)National Natural Science Foundation of China(No.62406205)National Natural Science Foundation of China(No.62206093).
文摘To the Editor:Gastroscopy is considered to be the main method for diagnosing gastric lesions.[1]But correctly diagnosing different gastric lesions under white light endoscopy(WLE)may be challenging as the morphological manifestations of gastric lesions are varied and some are even subtle.Due to the uneven diagnostic levels across various regions and the scarcity of experienced endoscopists,misdiagnosis and missed diagnosis may occur.In addition,endoscopists are overwhelmed by heavy workloads,and fatigue may lead to a further decline in diagnostic performance,even for experienced endoscopists.
文摘Endoscopic remission is the primary long-term therapeutic goal in inflammatory bowel disease(IBD).The assessment of this therapeutic target typically relies on white light endoscopy(WLE)combined with histological sampling.Nonetheless,distinguishing between endoscopic mild,patchy inflammation and quiescent disease can be challenging,and discrepancies have been observed between endoscopic and histological disease activity,mainly when using WLE.Recent advances in endoscopic technologies are gradually transforming clinical practice.Dye-based chromoendoscopy and virtual chromoendoscopy are currently available in the endoscopist armamentarium,enhancing the assessment of mucosal architecture and vascular patterns,improving the visualisation of patchy inflammation and helping detect subtle dysplastic colonic lesions.Moreover,novel advanced tools,including probe-based confocal laser endomicroscopy and endocytoscopy,offer the remarkable ability to investigate the deep aspect of the gastrointestinal tract in real time,including the structure and function of the intestinal barrier and inflammatory-related alterations.Thus,these techniques can bridge the gap between endoscopy and histology,enabling the integration of novel treat-to-target strategies associated with more favourable outcomes.Artificial intelligence(AI)represents a further step forward in overcoming the limitations associated with endoscopy,including subjectivity and the requirement for expertise.Their implementation in clinical practice may enable standardised,accurate and rapid disease assessment.Moreover,AI can aid in accurately predicting responses to therapy and disease outcomes by stratifying patients’risks,thereby advancing us towards patient-centred personalised medicine.This narrative review summarises the available advanced endoscopic technologies and their integration with AI to assess IBD activity,define promising therapeutic targets and predict long-term outcomes.
