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Artificial intelligence developed by and for the NHS at Addenbrooke’s reduces cancer patients’ wait for radiotherapy treatment

The first cloud-based AI technology to be developed and deployed within the NHS is saving doctors time and cutting the time patients wait between being referred for radiotherapy and starting treatment.

The new technology – known as “OSAIRIS” – enables specialists to plan radiotherapy treatments about two and half times faster than if they were working alone, ensuring more patients can get treatment sooner and improving the likelihood of cure.

The technology is currently being used at Addenbrooke’s for prostate and head and neck cancers but has the potential for use in patients across the NHS with many other types of cancer.

Led by Dr Raj Jena, oncologist at Cambridge University Hospitals NHS Foundation Trust, OSAIRIS works by significantly cutting the amount of time a doctor needs to spend drawing around healthy organs on scans before radiotherapy.

Outlining the organs, known as ‘segmentation’, is critical to protect the healthy tissue around the cancer from radiation but can take a doctor up to three hours per patient to perform this task. This complex but routine task is ideally suited to AI with the oncologist in control, checking every scan after OSAIRIS has done the segmentation.

OSAIRIS does much of the work in the background so that when the doctor sits down to start planning treatment, most of the heavy lifting is done. It is the first cloud-based AI technology to be developed and deployed within the NHS.

Raj Jena

“We’ve already started to work on a model that works in the chest, so that will work for lung cancer and breast cancer particularly.

“And also, from my perspective as a neuro-oncologist, I’m interested that we’re building the brain model so that we’ve got something that works for brain tumours as well,” explains Raj.

His research includes long-term collaborations with Microsoft Research on an AI research project known as Project InnerEye to develop machine learning techniques to support the global medical imaging community.

Raj Jena
Raj Jena

To broaden access to research in this field, Microsoft Research made available Project InnerEye toolkits as open-source software.

With a £500,000 grant from the NHS AI Lab, Raj’s team created OSAIRIS using open-source software from Project InnerEye and data from patients who had previously been treated in the hospital and agreed to contribute to the research.

Aditya Nori, General Manager of Healthcare for Microsoft Research, said: “By combining the power of AI with the world-class clinical expertise of the NHS, we have an amazing opportunity for revolutionising healthcare together, while preserving the human element that is the essence of high-quality and safe care.”

Rigorous tests and risk assessments were carried out to ensure OSAIRIS is safe and can be used in the day-to-day care of radiotherapy patients across the NHS.

In masked tests, known as ‘Turing tests’, doctors were unable to tell the difference between the work of OSAIRIS and the work of a doctor colleague.

Amy Edwards is a clinical engineer at CUH and was involved in the testing. She said: "Myself and the team essentially sit together and think of all the risks with this device, anything that could go wrong, any way in which it could be used incorrectly.

"And then we have to come up with some solutions to those risks and we have to make sure the device is safe to be used in all patients."

Raj added: "18 months of rigorous testing will enable us to share this technology safely across the NHS for patient benefit.”

Professor Sir Stephen Powis, NHS national medical director said: "Ever since the NHS was founded, it has been at the forefront of testing new technologies that could improve patient care and save lives – the NHS continues to take the lead in new AI technologies, like this one, to ensure our patients are among the first in the world to benefit."