Applications of Artificial Intelligence in Endobronchial Ultrasound for Lung Cancer Diagnosis and Staging: A Scoping Review

Introduction: Lung cancer remains highly lethal. Endobronchial ultrasound (EBUS) enables minimally invasive diagnosis and staging. Artificial intelligence (AI) improves image analysis and diagnostic accuracy, though current evidence is limited by retrospective, small, single center studies. Methods: A scoping review following Arksey–O’Malley, Levac, and JBI frameworks, was reported as per PRISMA-ScR. Databases were searched for studies (2015–2026) on AI in EBUS. Two reviewers screened, extracted standardized data, and performed narrative synthesis grouped by algorithm type, application, and performance metrics. Results: A total of 26 studies were included. Of these, 73.1% (19/26) employed deep learning-based models, while 26.9% (7/26) used traditional or hybrid machine learning approaches. The most frequent clinical objective was diagnostic classification of malignancy (14/26; 53.8%), followed by segmentation or cytological analysis (5/26; 19.2%), anatomical navigation or lymph node station classification (3/26; 11.5%), and multimodal predictive or staging support models (4/26; 15.4%). Most studies were based on EBUS-derived images or videos (18/26; 69.2%), including both convex-probe and radial-probe applications. Studies were distributed among Convex Probe-EBUS for mediastinal staging, Radial Probe-EBUS for peripheral lesion assessment, and rapid on-site evaluation-based cytology analysis, reflecting diverse clinical contexts. Most models were developed using static images. Conclusions: AI applications in EBUS are predominantly based on deep learning and mainly focused on diagnostic classification, with growing but still limited exploration of segmentation, navigation, and multimodal approaches. The evidence reflects diverse clinical contexts and data sources, particularly image-based inputs, but remains unevenly distributed across applications.