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."