{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T18:35:27Z","timestamp":1775673327252,"version":"3.50.1"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"10","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims Artificial intelligence (AI) models have demonstrated high diagnostic performance identifying neoplasia during digital single-operator cholangioscopy (DSOC). To date, there are no studies directly comparing AI vs. DSOC-guided probe-base confocal laser endomicroscopy (DSOC-pCLE). Thus, we aimed to compare the diagnostic accuracy of a DSOC-based AI model with DSOC-pCLE for identifying neoplasia in patients with indeterminate biliary strictures.<\/jats:p><jats:p>\n            Patients and methods This retrospective cohort-based diagnostic accuracy study included patients \u2265 18 years old who underwent DSOC and DSOC-pCLE (June 2014 to May 2022). Four methods were used to diagnose each patient's biliary structure, including DSOC direct visualization, DSOC-pCLE, an offline DSOC-based AI model analysis performed in DSOC recordings, and DSOC\/pCLE-guided biopsies. The reference standard for neoplasia was a diagnosis based on further clinical evolution, imaging, or surgical specimen findings during a 12-month follow-up period.<\/jats:p><jats:p>\n            Results A total of 90 patients were included in the study. Eighty-six of 90 (95.5%) had neoplastic lesions including cholangiocarcinoma (98.8%) and tubulopapillary adenoma (1.2%). Four cases were inflammatory including two cases with chronic inflammation and two cases of primary sclerosing cholangitis. Compared with DSOC-AI, which obtained an area under the receiver operator curve (AUC) of 0.79, DSOC direct visualization had an AUC of 0.74 (P = 0.763), DSOC-pCLE had an AUC of 0.72 (P = 0.634), and DSOC- and pCLE-guided biopsy had an AUC of 0.83 (P = 0.809).<\/jats:p><jats:p>\n            Conclusions The DSOC-AI model demonstrated an offline diagnostic performance similar to that of DSOC-pCLE, DSOC alone, and DSOC\/pCLE-guided biopsies. Larger multicenter, prospective, head-to-head trials with a proportional sample among neoplastic and nonneoplastic cases are advisable to confirm the obtained results.<\/jats:p>","DOI":"10.1055\/a-2404-5699","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T23:04:34Z","timestamp":1728601474000},"page":"E1118-E1126","source":"Crossref","is-referenced-by-count":9,"title":["Cholangioscopy-based convoluted neuronal network vs. confocal laser endomicroscopy in identification of neoplastic biliary strictures"],"prefix":"10.1055","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2434-3369","authenticated-orcid":false,"given":"Carlos","family":"Robles-Medranda","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Baquerizo-Burgos","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Puga-Tejada","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenica","family":"Cunto","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Egas-Izquierdo","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Mendez","sequence":"additional","affiliation":[{"name":"Research and Development, mdconsgroup, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2561-8512","authenticated-orcid":false,"given":"Martha","family":"Arevalo-Mora","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Alcivar Vasquez","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Lukashok","sequence":"additional","affiliation":[{"name":"Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas \u2013 IECED, Guayaquil, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Tabacelia","sequence":"additional","affiliation":[{"name":"Gastroenterology, Elias Emergency University Hospital, Bucuresti, Romania"},{"name":"Universitatea de Medicin\u0103 \u0219i Farmacie Carol Davila din Bucure\u0219ti, Bucuresti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"924","DOI":"10.5946\/ce.2020.191","article-title":"High-resolution probe-based confocal laser endomicroscopy for diagnosing biliary diseases","volume":"54","author":"H Koda","year":"2021","journal-title":"Clin Endosc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.21037\/tgh.2020.04.02","article-title":"Confocal laser endomicroscopy in gastro-intestinal endoscopy: technical aspects and clinical 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