{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T09:08:59Z","timestamp":1778231339941,"version":"3.51.4"},"reference-count":38,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NVIDIA"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Digital single-operator cholangioscopy (D-SOC) has enhanced the ability to diagnose indeterminate biliary strictures (BSs). Pilot studies using artificial intelligence (AI) models in D-SOC demonstrated promising results. Our group aimed to develop a convolutional neural network (CNN) for the identification and morphological characterization of malignant BSs in D-SOC. A total of 84,994 images from 129 D-SOC exams in two centers (Portugal and Spain) were used for developing the CNN. Each image was categorized as either a normal\/benign finding or as malignant lesion (the latter dependent on histopathological results). Additionally, the CNN was evaluated for the detection of morphologic features, including tumor vessels and papillary projections. The complete dataset was divided into training and validation datasets. The model was evaluated through its sensitivity, specificity, positive and negative predictive values, accuracy and area under the receiver-operating characteristic and precision-recall curves (AUROC and AUPRC, respectively). The model achieved a 82.9% overall accuracy, 83.5% sensitivity and 82.4% specificity, with an AUROC and AUPRC of 0.92 and 0.93, respectively. The developed CNN successfully distinguished benign findings from malignant BSs. The development and application of AI tools to D-SOC has the potential to significantly augment the diagnostic yield of this exam for identifying malignant strictures.<\/jats:p>","DOI":"10.3390\/cancers15194827","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T04:28:08Z","timestamp":1696220888000},"page":"4827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Deep Learning for Automatic Diagnosis and Morphologic Characterization of Malignant Biliary Strictures Using Digital Cholangioscopy: A Multicentric Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-0830","authenticated-orcid":false,"given":"Miguel Mascarenhas","family":"Saraiva","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"}]},{"given":"Tiago","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"}]},{"given":"Mariano","family":"Gonz\u00e1lez-Haba","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario Puerta de Hierro Majadahonda, C\/Joaqu\u00edn Rodrigo, 28220 Majadahonda, Madrid, Spain"}]},{"given":"Bel\u00e9n","family":"Agudo Castillo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario Puerta de Hierro Majadahonda, C\/Joaqu\u00edn Rodrigo, 28220 Majadahonda, Madrid, Spain"}]},{"given":"Jo\u00e3o P. S.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"},{"name":"DigestAID\u2014Digestive Artificial Intelligence Development, Rua Alfredo Allen n.\u00ba 455\/461, 4200-135 Porto, Portugal"}]},{"given":"Filipe","family":"Vilas Boas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"}]},{"given":"Jo\u00e3o","family":"Afonso","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"}]},{"given":"Francisco","family":"Mendes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0484-4804","authenticated-orcid":false,"given":"Miguel","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"}]},{"given":"Pedro","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"}]},{"given":"Pedro","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-9872","authenticated-orcid":false,"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-427 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/j.1572-0241.2007.01645.x","article-title":"Management of hilar biliary strictures","volume":"103","author":"Larghi","year":"2008","journal-title":"Am. 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