{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:23:13Z","timestamp":1783596193744,"version":"3.55.0"},"reference-count":33,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Accurate mediastinal and hilar lymph node (LN) assessment is central to lung cancer staging and treatment selection. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the standard minimally invasive procedure for mediastinal staging, enabling real-time identification, characterization and sampling of LNs. Although effective, this technique remains operator dependent, and subject to interobserver variability. This study aims to report the development of a Vision Transformer-based AI model for automatic LN detection and classification on EBUS images. Methods: A multicenter, multidevice, retrospective study, using EBUS images of three referral centers (Spain and Brazil). The dataset included images of patients with benign and malignant LNs. Bounding-box annotations were applied for LN localization, and LNs were classified as benign or malignant according to histopathologic reference standards. Detection performance was evaluated with mean average precision, at an intersection over union threshold of 0.5 (mAP50). Characterization performance was assessed using accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). Results: The dataset included 6492 images from 27 patients, of whom 16 had malignant LNs. In the test set, the model achieved a mAP50 of 0.79 for LN detection. For malignant characterization, the model achieved an accuracy of 90.6%, sensitivity of 85.4%, and an AUROC of 0.938. Conclusions: The results of this study support the feasibility of AI-assisted EBUS interpretation for nodal staging workflows and raise the possibility that AI-assisted EBUS could enhance diagnostic performance, while reducing operator variability. Larger prospective studies are needed before clinical implementation.<\/jats:p>","DOI":"10.3390\/jcm15145356","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:16:22Z","timestamp":1783592182000},"page":"5356","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Artificial Intelligence and Endobronchial Ultrasound for Lymph-Node Detection and Characterization: A Pioneer Multicenter Transatlantic Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-0830","authenticated-orcid":false,"given":"Miguel","family":"Mascarenhas","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Precision Medicine Unit, Department of Gastroenterology, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"World Gastroenterology Organization Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema Diaz","family":"Nuevo","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9166-9508","authenticated-orcid":false,"given":"Sara","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Instituto Portugu\u00eas de Oncologia-Porto, 4200-072 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Puertas","family":"Sancho","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Lopez","family":"Garcia-Gallo","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza Bicudo de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-9142","authenticated-orcid":false,"given":"Miriam","family":"Chinzon","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0352-9222","authenticated-orcid":false,"given":"Larissa Mercadante de","family":"Assis","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Ejima","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fauze","family":"Maluf-Filho","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Ferreira","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1201-0113","authenticated-orcid":false,"given":"Thom\u00e1s Paiva Lima","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Hospital S\u00e3o Luiz-Rede D\u2019Or, S\u00e3o Paulo 04544-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabele Alves","family":"Chirichela","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Hospital S\u00e3o Luiz-Rede D\u2019Or, S\u00e3o Paulo 04544-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Precision Medicine Unit, Department of Gastroenterology, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"World Gastroenterology Organization Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"},{"name":"Department of Medicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5890-7049","authenticated-orcid":false,"given":"Francisco","family":"Mendes","sequence":"additional","affiliation":[{"name":"Precision Medicine Unit, Department of Gastroenterology, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"World Gastroenterology Organization Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"},{"name":"Department of Medicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2504-351X","authenticated-orcid":false,"given":"Bel\u00e9n","family":"Agudo Castillo","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f3nio Pinto da","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8025-1704","authenticated-orcid":false,"given":"Mariano","family":"Gonz\u00e1lez-Haba","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0887-8796","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-9872","authenticated-orcid":false,"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Precision Medicine Unit, Department of Gastroenterology, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"World Gastroenterology Organization Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"},{"name":"Department of Medicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8023-3722","authenticated-orcid":false,"given":"Eduardo Guimar\u00e3es Hourneaux De","family":"Moura","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0134-9357","authenticated-orcid":false,"given":"Jo\u00e3o Marcelo Lopes Toscano de","family":"Brito","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Hospital S\u00e3o Luiz-Rede D\u2019Or, S\u00e3o Paulo 04544-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago Noguchi","family":"Machuca","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Hospital S\u00e3o Luiz-Rede D\u2019Or, S\u00e3o Paulo 04544-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Rog\u00e9rio","family":"Scordamaglio","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Hospital S\u00e3o Luiz-Rede D\u2019Or, S\u00e3o Paulo 04544-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Nominando Diniz","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelino F.","family":"Leite-Moreira","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Cardiothoracic Surgery, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, 4200-437 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1164\/rccm.200210-1181SO","article-title":"Central airway obstruction","volume":"169","author":"Ernst","year":"2004","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1136\/thoraxjnl-2013-203618","article-title":"British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: Accredited by NICE","volume":"68","author":"Blaikley","year":"2013","journal-title":"Thorax"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lopes, S., Mascarenhas, M., Fonseca, J., and Leite-Moreira, A.F. (2026). Artificial Intelligence in Pulmonary Endoscopy: Current Evidence, Limitations, and Future Directions. J. Imaging, 12.","DOI":"10.3390\/jimaging12040167"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"249","DOI":"10.6004\/jnccn.2204.0023","article-title":"Non-Small Cell Lung Cancer, Version 4.2024, NCCN Clinical Practice Guidelines in Oncology","volume":"22","author":"Riely","year":"2024","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_5","unstructured":"National Comprehensive Cancer Network (2026, May 24). Non-Small Cell Lung Cancer (Version 5.2026). Available online: https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1450."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1136\/thx.2005.047829","article-title":"Real-time endobronchial ultrasound guided transbronchial needle aspiration for sampling mediastinal lymph nodes","volume":"61","author":"Herth","year":"2006","journal-title":"Thorax"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e211S","DOI":"10.1378\/chest.12-2355","article-title":"Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"143","author":"Silvestri","year":"2013","journal-title":"Chest"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1097\/JTO.0b013e318153fd8d","article-title":"Endobronchial ultrasonography: Current status and future directions","volume":"2","author":"Yasufuku","year":"2007","journal-title":"J. Thorac. Oncol."},{"key":"ref_9","first-page":"PA4248","article-title":"Quality standards assessment in Bronchoscopy Services; friend or foe","volume":"50","author":"Verghese","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Agudo Castillo, B., Mascarenhas Saraiva, M., Pinto da Costa, A.M.M., Ferreira, J., Martins, M., Mendes, F., Cardoso, P., Mota, J., Almeida, M.J., and Afonso, J. (2025). Artificial Intelligence for Lymph Node Detection and Malignancy Prediction in Endoscopic Ultrasound: A Multicenter Study. Cancers, 17.","DOI":"10.3390\/cancers17213398"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"117","DOI":"10.4103\/atm.atm_192_23","article-title":"Artificial intelligence in respiratory care: Current scenario and future perspective","volume":"19","author":"Alanazi","year":"2024","journal-title":"Ann. Thorac. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41591-018-0300-7","article-title":"High-performance medicine: The convergence of human and artificial intelligence","volume":"25","author":"Topol","year":"2019","journal-title":"Nat. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e271","DOI":"10.1016\/S2589-7500(19)30123-2","article-title":"A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: A systematic review and meta-analysis","volume":"1","author":"Liu","year":"2019","journal-title":"Lancet Digit. Health"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ervik, \u00d8., R\u00f8dde, M., Hofstad, E.F., Tveten, I., Lang\u00f8, T., Leira, H.O., Amundsen, T., and Sorger, H. (2025). A New Deep Learning-Based Method for Automated Identification of Thoracic Lymph Node Stations in Endobronchial Ultrasound (EBUS): A Proof-of-Concept Study. J. Imaging, 11.","DOI":"10.3390\/jimaging11010010"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"13710","DOI":"10.1038\/s41598-022-17976-5","article-title":"Deep learning-based diagnosis from endobronchial ultrasonography images of pulmonary lesions","volume":"12","author":"Hotta","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Tang, F., Zha, X.K., Ye, W., Wang, Y.M., Wu, Y.F., Wang, L.N., Lyu, L.P., and Lyu, X.M. (2025). Artificial intelligence-assisted endobronchial ultrasound for differentiating between benign and malignant thoracic lymph nodes: A meta-analysis. BMC Pulm. Med., 25.","DOI":"10.1186\/s12890-025-03760-4"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1093\/jjco\/hyu105","article-title":"Endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph nodes","volume":"44","author":"Izumo","year":"2014","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.chest.2016.03.063","article-title":"Technical Aspects of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration","volume":"150","author":"Delage","year":"2016","journal-title":"CHEST"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1148\/rg.2017160130","article-title":"Machine Learning for Medical Imaging","volume":"37","author":"Erickson","year":"2017","journal-title":"Radiographics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1038\/s41746-020-00376-2","article-title":"Deep learning-enabled medical computer vision","volume":"4","author":"Esteva","year":"2021","journal-title":"npj Digit. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1038\/s41467-023-44385-7","article-title":"AI co-pilot bronchoscope robot","volume":"15","author":"Zhang","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1038\/s41591-019-0447-x","article-title":"End-to-end lung cancer screening with three-dimensional deep learning on low-dose chest computed tomography","volume":"25","author":"Ardila","year":"2019","journal-title":"Nat. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Tran, D., Bourdev, L., Fergus, R., Torresani, L., and Paluri, M. (2015, January 7\u201313). Learning spatiotemporal features with 3D convolutional networks. Proceedings of the IEEE International Conference on Computer Vision, Santiago, Chile.","DOI":"10.1109\/ICCV.2015.510"},{"key":"ref_24","unstructured":"Dosovitskiy, A., Beyer, L., Kolesnikov, A., Weissenborn, D., Zhai, X., Unterthiner, T., Dehghani, M., Minderer, M., Heigold, G., and Gelly, S. (2020). An image is worth 16x16 words: Transformers for image recognition at scale. arXiv."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1136\/gutjnl-2018-317500","article-title":"Real-time automatic detection system increases colonoscopic polyp and adenoma detection rates: A prospective randomised controlled study","volume":"68","author":"Wang","year":"2019","journal-title":"Gut"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Chudobinski, C., Pasicz, K., Hanke, M., Kaczmarek, A., Pajdzinski, M., Kolacinska-Wow, A., Gottwald, L., Kuncman, W., Podgorski, M., and Cieszanowski, A. (2025). Lymph Node Reporting and Data System (LN-RADS)-Retrospective Evaluation for Ultrasound Classification of Superficial Lymph Nodes. Cancers, 17.","DOI":"10.3390\/cancers17122030"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.chest.2024.05.026","article-title":"The Proposed Ninth Edition TNM Classification of Lung Cancer","volume":"166","author":"Detterbeck","year":"2024","journal-title":"CHEST"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1038\/s41591-018-0177-5","article-title":"Classification and mutation prediction from non-small cell lung cancer histopathology images using deep learning","volume":"24","author":"Coudray","year":"2018","journal-title":"Nat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zhi, X., Li, J., Chen, J., Wang, L., Xie, F., Dai, W., Sun, J., and Xiong, H. (2021). Automatic Image Selection Model Based on Machine Learning for Endobronchial Ultrasound Strain Elastography Videos. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.673775"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"036002","DOI":"10.1117\/1.JMI.11.3.036002","article-title":"Automatic lesion detection for narrow-band imaging bronchoscopy","volume":"11","author":"Daneshpajooh","year":"2024","journal-title":"J. Med. Imaging"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/(SICI)1522-712X(1995)1:4<217::AID-IGS4>3.0.CO;2-D","article-title":"Computer-assisted bronchoscopy: Aims and research perspectives","volume":"1","author":"Bricault","year":"1995","journal-title":"J. Image Guid. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"00395-2024","DOI":"10.1183\/23120541.00395-2024","article-title":"Artificial intelligence improves bronchoscopy performance: A randomised crossover trial","volume":"11","author":"Cold","year":"2025","journal-title":"ERJ Open Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"160018","DOI":"10.1038\/sdata.2016.18","article-title":"The FAIR Guiding Principles for scientific data management and stewardship","volume":"3","author":"Wilkinson","year":"2016","journal-title":"Sci. Data"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5356\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:36:18Z","timestamp":1783593378000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":33,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15145356"],"URL":"https:\/\/doi.org\/10.3390\/jcm15145356","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]}}}