{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:59:06Z","timestamp":1790305146572,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Study Aims<\/jats:title>\n                    <jats:p>Pancreatobiliary endoscopic ultrasonography (EUS) is technically demanding, and supervised training opportunities are limited. We developed an artificial intelligence (AI) overlay system for detecting solid pancreatic lesions (SPL) and recognizing pancreatic parenchyma (PP) and evaluated its effect on reader performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Across six centers, two deep learning\u2010based models were trained using expert\u2010annotated EUS frames. We then conducted a randomized, two\u2010sequence, two\u2010period crossover reader study in which eight endosonographers (five novices and three experts) interpreted image sets with and without AI assistance. The primary endpoint was superiority of sensitivity for SPL detection among novices; key secondary endpoints included specificity and PP recognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 118 patients, 120 SPL\u2010positive\/negative image sets and 160 PP\u2010positive\/negative image sets were constructed. Among novices, AI assistance improved SPL detection sensitivity (88.7% vs. 76.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and accuracy (86.4% vs. 78.7%), while specificity met the predefined noninferiority criterion (84.2% vs. 80.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). For PP recognition, sensitivity increased numerically (86.3% vs. 83.3%) but did not meet the predefined superiority criterion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.095); specificity met the noninferiority criterion (87.8% vs. 81.0%), and accuracy increased from 82.1% to 87.0%. Among experts, sensitivity was maintained for both tasks, whereas specificity increased with AI assistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AI assistance improved SPL detection among novice endosonographers. For PP recognition, sensitivity increased without reaching statistical superiority, whereas specificity met the predefined noninferiority criterion. These findings support a potential adjunctive role for AI in EUS interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70282","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:35:31Z","timestamp":1789043731000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Crossover Evaluation of an Artificial Intelligence\u2010Assisted System for Solid Pancreatic Lesion Detection and Pancreatic Parenchyma Recognition in Endoscopic Ultrasonography (With Video)"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7367-0767","authenticated-orcid":false,"given":"Toshio","family":"Fujisawa","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Juntendo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8348-8926","authenticated-orcid":false,"given":"Takamichi","family":"Kuwahara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Aichi Cancer Center  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5142-4706","authenticated-orcid":false,"given":"Tatsuya","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5036-4545","authenticated-orcid":false,"given":"Yusuke","family":"Takasaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Juntendo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6376-687X","authenticated-orcid":false,"given":"Nozomi","family":"Okuno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Aichi Cancer Center  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7653-7689","authenticated-orcid":false,"given":"Ryunosuke","family":"Hakuta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6206-9236","authenticated-orcid":false,"given":"Ko","family":"Tomishima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Juntendo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7578-5610","authenticated-orcid":false,"given":"Shin","family":"Haba","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Aichi Cancer Center  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1265-3100","authenticated-orcid":false,"given":"Naminatsu","family":"Takahara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0777-8215","authenticated-orcid":false,"given":"Yukiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Japanese Red Cross Medical Center  Tokyo 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