Artificial intelligence in EUS for autoimmune pancreatitis: bias and real life

The diagnosis of autoimmune pancreatitis (AIP) is often challenging and distinguishing it from chronic pancreatitis or pancreatic cancer (PC) could be very difficult. In particular, AIP can present at CT scan, MRI or endoscopic ultrasound (EUS) as a focal mass, sometimes with no other specific peculiarities. Furthermore, current international guidelines1 2 consider EUS only as a way to obtain cyto-histological specimens to exclude malignancy, regardless to its diagnostic capacity based on morphologic aspects. For these reasons, we read with great interest the paper by Marya et al 3 about the possible role of a new EUS-convolutional neural network (EUS-CNN) model for the diagnosis of AIP. In this model, videos and pictures of EUS, accurately preselected by the endosonographers, were evaluated …