AI-assisted digital cholangioscopy for indeterminate and malignant biliary strictures: 5 studies, 675 lesions, pooled sensitivity 95% and specificity 88%
This systematic review and meta-analysis pooled 5 studies (675 lesions; 2,685,674 cholangioscopic images) using PRISMA, MOOSE, and Cochrane Diagnostic Test Accuracy methodology with a bivariate model, and found that AI-assisted cholangioscopy—mostly deep learning systems using convolutional neural networks at roughly 30 to 60 frames per second—achieved a pooled sensitivity of 95% (95% CI: 85-98), specificity of 88% (95% CI: 76-94), and diagnostic accuracy (SROC) of 97% (95% CI: 95-98) for indeterminate or malignant biliary strictures, with a CNN-only sensitivity analysis (4 studies, 538 patients) showing consistent results, leading the authors to call the approach promising.