The impact of Artificial Intelligence in detecting esophageal squamous cell carcinoma: advances and challenges

Abstract

This review explores the transformative role of artificial intelligence (AI), especially through deep learning (DL) and convolutional neural networks (CNNs), in the early detection of esophageal squamous cell carcinoma (ESCC). ESCC presents significant diagnostic challenges due to its aggressive nature and high mortality, often diagnosed at advanced stages. Traditional endoscopic methods, while essential, suffer from limitations like interobserver variability, especially for subtle early lesions. AI-based systems have demonstrated high sensitivity in identifying these early neoplasms, reducing diagnostic discrepancies and enhancing precision. Through a bibliographic review, the article highlights recent AI advancements, particularly in utilizing CNNs to identify early-stage ESCC. These tools have shown the potential to improve diagnostic accuracy even among less experienced endoscopists and provide critical support in clinical decision-making, including biopsy guidance and lesion mapping in chromoendoscopy and narrow-band imaging (NBI). Despite promising results, challenges persist in AI’s practical application, such as the need for extensive data for training, clinical validation, and standardization across different endoscopic equipment. The study underscores the need for large-scale multicenter studies and standardization to solidify AI’s role in ESCC diagnosis. It envisions a future where AI not only serves as a diagnostic support tool but becomes integral to endoscopic practices, requiring continued technological development, ethical considerations, and regulatory frameworks to maximize clinical benefit.