The cutting-edge evolution of artificial intelligence-assisted capsule endoscopy

Since its introduction in 2000, capsule endoscopy (CE) has transformed gastrointestinal (GI) diagnostics by enabling noninvasive visualization of the entire GI tract using a swallowable capsule. However, CE still has several limitations, including long reading times, inter-reader variability, and missed lesions due to poor image quality or incomplete examinations. Recent advances in artificial intelligence (AI) have significantly improved CE interpretation. Deep-learning models, particularly convolutional neural networks, can detect small-bowel lesions with accuracy comparable to that of expert endoscopists, while greatly reducing reading time. AI algorithms can also provide objective assessments of small-bowel cleanliness. Transformer-based models can further enhance video-level analysis by recognizing global patterns and sequential relationships among CE images. In addition, foundation models demonstrate high adaptability and robust performance across different CE systems and a wide range of lesion types. Future AI-assisted CE reading is expected to integrate real-time image analysis, autonomous capsule movement, and multimodal sensing technologies to create an intelligent diagnostic platform. Ultimately, AI is transforming CE into an efficient, reliable, and data-driven diagnostic tool suitable for diverse clinical settings. Furthermore, AI-assisted CE is extending its clinical utility beyond small-bowel lesion detection to the comprehensive evaluation of the stomach and colon.