United
Lincolnshire Hospitals NHS Trust (ULHT) is one of only two Trusts in
the country to take part in a groundbreaking new trial using artificial
intelligence (AI) to support breast screening.
ULHT is part of the East Midlands Radiology Consortium (EMRAD), a
partnership of seven NHS trusts, spread over 11 hospitals, looking after
more than five million patients.
EMRAD launched in 2013 with the objective to create the foundations for
stronger clinical collaboration, starting with the implementation of a
new, common digital radiology system. This pioneering work saw the East
Midlands become the first health community
in the UK where NHS hospitals could quickly and easily share diagnostic
images such as x-rays and scans. The image-sharing system has set the
national benchmark for a new model of clinical collaboration within
radiology services in the NHS.
Currently all images produced during breast screenings, known as
mammograms, are reviewed by two members of the breast screening reading
team. With a national shortage of radiologists and with almost a quarter
planning to retire within the next five years,
there is a clear need to investigate and look for potential
alternatives.
Last year, the consortium formed a partnership with two UK-based AI
companies, Faculty and Kheiron Medical, to help develop, test and
ultimately deploy AI tools in the breast cancer screening programme in
the East Midlands.
Faculty’s ‘Platform’ software has the potential to help optimise clinic
scheduling and staff resourcing, helping the service to be as efficient
and effective as possible. The aim is to make the best possible use of
scarce resources like radiologists’ time and
scanners, and to reduce stress on the clinical and administrative
workforce delivering the programme.
Kheiron Medical’s MIA (mammography intelligent assessment) tool uses an
AI algorithm to try and diagnose breast cancer. The algorithm has been
used on half a million scans from hospitals in Hungary, but it is new to
the UK. The UK trial is using scans from
ULHT and Nottingham University Hospitals NHS Trust.
The first phase is a retrospective trial where old images have been
anonymised and used to see how accurate MIA is at diagnosing scans that
need further investigation, compared to the results produced by the
breast screening reading team. Already, it is performing
better than most humans.
If the evidence shows that it is safe to do so, then the next stage will
see the team use MIA to do the first read of all scans before they are
then reviewed by a member of the radiology team and the results
compared. If there is any difference of opinion then
the scan will automatically be sent for a third read.
ULHT Consultant Mammographer and the Trust’s lead on the project,
Bernadette Trzcinski, said: “I am really excited to be working on this
trial, which may revolutionise how we read scans in the future.
“Across the country we desperately need something to help us with the
current staff shortages, which are predicted to become increasingly
challenging as the demand for imaging grows. The success of this project
will transform the breast screening service, improving
both quality and efficiency for our breast screening population.
“It is not about replacing radiologists. All scans at the Trust will
continue to be read by at least one member of the breast screening
reading team. However if MIA is successful, it has the potential to half
the amount of time we spend reviewing scans, this
is time we could be spending with our patients, improving their overall
experience.”
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