Application of Artificial Intelligence Technology in the Comprehensive Management of Chronic Liver Disease: A Narrative Review on Technological Advances and Clinical Prospects

Artificial intelligence (AI) is transforming the diagnosis and treatment of chronic liver diseases in an unprecedented way, from the laboratory to clinical practice. AI has achieved significant progress across multiple domains, including radiomics, digital pathology and multimodal clinical decision support systems. This article provides a comprehensive review of current AI applications in the holistic management of chronic liver diseases, encompassing machine learning and deep learning, generative AI and large language models, digital twin systems, radiomics and digital pathology, digital health technologies and multimodal data integration. Machine learning aids in early encephalopathy detection and cirrhosis nutrition; generative AI, digital twins, imaging biomarkers and digital pathology show potential, with digital pathology as a new trial endpoint. Currently, however, AI still faces considerable challenges in the field of chronic liver disease. Even after achieving technological breakthroughs, translating these advances into routine clinical practice requires overcoming multiple obstacles, including limited generalizability, the difficulty of balancing clinical practicality with model complexity, insufficient explainability, data heterogeneity, ethical and fairness concerns, and unclear regulatory approval pathways. Therefore, the key to the success of future clinical translation lies in conducting multi-center prospective validation, developing interpretable AI frameworks, designing deployment strategies that meet clinical needs, and actively designing algorithms centered on patients to ensure their fairness. Only when development is carried out responsibly, and deployment is reasonable, can AI truly transform the comprehensive management model for chronic liver diseases and provide clinical doctors with powerful, reliable decision-making support tools.