Artificial intelligence in esophageal cancer diagnosis and treatment: where are we now?—a narrative review

BACKGROUND AND OBJECTIVE: Artificial intelligence (AI) use is becoming increasingly prevalent directly or indirectly in daily clinical practice, including esophageal cancer (EC) diagnosis and treatment. Although the limits of its adoption and their clinical benefits are still unknown, any physician related to EC patients’ management should be aware of the status and future perspectives of AI use in their field. The purpose of this review is to summarize the existing literature regarding the role of AI in diagnosis and treatment of EC. We have focused on the aids AI entails in the management of this pathology and we have tried to offer an updated perspective to maximize current applications and to identify potential future uses of it. METHODS: Data concerning AI applied to EC diagnosis and treatment is not limited, including direct (those specifically related to them) and indirect (those referring to other specialties as radiology or pathology), applications. However, the clinical relevance of the discussed and presented models is still unknown. We performed a research in PubMed of English and Spanish written studies from January 1970 to June 2022. KEY CONTENT AND FINDINGS: Information regarding the role of AI in EC diagnosis and treatment has increased exponentially in recent years. Several models, including different variables and features have been investigated and some of them internally and externally validated. However, the main challenge remains to apply and introduce all these data into clinical practice, and, as some of the discussed studies argue, if the models are able to enhance experienced endoscopists’ judgement. Although AI use is increasing steadily in different medical specialties, the truth is, most of the time, the gap between model development and clinical implementation is not closed. Learning to understand the routinely application of AI, as well as future improvements, would lead to a broadened adoption. CONCLUSIONS: Physicians should be aware of the multiple current clinical uses of AI in EC diagnosis and treatment and should take part in their clinical application and future developments to enhance patient care.