Diagnostic value of deep learning-assisted endoscopic ultrasound for pancreatic tumors: a systematic review and meta-analysis

Background and aims: Endoscopic ultrasonography (EUS) is commonly utilized in the diagnosis of pancreatic tumors, although as this modality relies primarily on the practitioner’s visual judgment, it is prone to result in a missed diagnosis or misdiagnosis due to inexperience, fatigue, or distraction. Deep learning (DL) techniques, which can be used to automatically extract detailed imaging features from images, have been increasingly beneficial in the field of medical image-based assisted diagnosis. The present systematic review included a meta-analysis aimed at evaluating the accuracy of DL-assisted EUS for the diagnosis of pancreatic tumors diagnosis. Methods: We performed a comprehensive search for all studies relevant to EUS and DL in the following four databases, from their inception through February 2023: PubMed, Embase, Web of Science, and the Cochrane Library. Target studies were strictly screened based on specific inclusion and exclusion criteria, after which we performed a meta-analysis using Stata 16.0 to assess the diagnostic ability of DL and compare it with that of EUS practitioners. Any sources of heterogeneity were explored using subgroup and meta-regression analyses. Results: A total of 10 studies, involving 3,529 patients and 34,773 training images, were included in the present meta-analysis. The pooled sensitivity was 93% (95% confidence interval [CI], 87–96%), the pooled specificity was 95% (95% CI, 89–98%), and the area under the summary receiver operating characteristic curve (AUC) was 0.98 (95% CI, 0.96–0.99). Conclusion: DL-assisted EUS has a high accuracy and clinical applicability for diagnosing pancreatic tumors. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023391853, identifier CRD42023391853.