Using Artificial Intelligence for faster Chest X-ray results

North East London Cancer Alliance is leading an initiative to integrate Artificial Intelligence (AI) into cancer diagnostic pathways. This project aims to reduce the wait time for chest X-ray results from three weeks to just three days for scans with significant findings.

In collaboration with Sectra and Qure.ai, North East London Cancer Alliance is using the Sectra Amplifier services integrating qXR (Qure X-Ray) AI tool to help radiologists and reporting radiographers prioritise urgent cases, enhance decision-making, and streamline the patient journey.

This is a collaboration between Barts Health NHS Trust, Barking, Havering, and Redbridge University Hospitals NHS Trust, and Homerton Healthcare NHS Foundation Trust.

Overcoming the challenges in north east London

North east London is facing significant workforce challenges and a sharp rise in demand for chest X-rays. In 2017, 139,080 chest X-rays were performed, and by 2022, that number had surged to 270,000 - a 94% increase in just five years. In addition to this, the UK is facing a 29% shortfall in radiologists.

Using AI will help tackle these issues by improving decision-making and prioritising urgent cases, helping to reduce delays and streamline the diagnostic process.

AI is now being used at Barts Health NHS Trust, Barking, Havering, and Redbridge University Hospitals NHS Trust, and Homerton Healthcare NHS Foundation Trust for the first time, where it is being integrated into chest X-ray pathways to ensure the timely identification of significant findings.

This initiative, aligned with the National Optimal Lung Cancer Pathway (NOLCP) guidelines, aims to provide confidence for healthcare professionals, improve patient outcomes, and streamline radiology workflows.

Ensuring patient safety

By integrating AI-driven software into diagnostic workflows, North East London Cancer Alliance aims to improve clinical decision-making and drive efficiency, whilst at the same time maintaining the highest levels of patient safety and care and adhering to national guidelines for lung cancer pathways.

By prioritising urgent cases and quickly sorting through normal ones (X-rays finds nothing requiring medical intervention), the AI system reduces delays in diagnosing critical conditions like lung cancer. This means patients can receive faster treatment when needed, improving their outcomes by ensuring timely care. For those without cancer, the system provides quicker reassurance, giving them peace of mind sooner.

The technology is used to assist, rather than replace, the specialist teams working on respiratory conditions (diseases of the lung and airways). North East London Cancer Alliance is also supporting a national evaluation of this rollout, as well as a local one to highlight the benefits to our local population.

Oliver Hawkins, Senior Project Manager for North East London Cancer Alliance, says: “It has been great working with Qure.ai and Sectra to deliver an AI-driven solution aimed at revolutionising diagnostic pathways in north east London. This provides patients with faster access to crucial diagnostic tests and improves overall healthcare delivery.”

Delivering benefits across north east London

The key features of introducing this technology are:

• AI-driven triage: The software will assist in the rapid identification and prioritisation of chest X-ray findings which could indicate lung cancer, facilitating timely intervention and treatment
   
• Fast-tracking: The solution aims to speed up the diagnostic process and improve patient outcomes.
   
• Point-of-care delivery: The software will be accessible at the point of care, ensuring seamless integration into existing diagnostic protocols across all NHS hospitals in north east London

The key benefits are:

• Improved patient care: Timely identification and fast-tracking of suspicious findings will enable early intervention and treatment – as well as giving peace of mind sooner to patients where nothing is found - enhancing patient outcomes and satisfaction.
   
• Enhanced efficiency: AI-driven triage and prioritisation will optimise use of our workforce and reduce waiting times, leading to improved workflow efficiency.
   
• Adherence to guidelines: By aligning with NHS England's national optimal lung cancer pathway guidelines, the solution ensures consistent and high-quality care delivery.

A view from North East London Cancer Alliance's partners

Surabhi Srivastava, Head of UK Business at Qure.ai says: “We’re delighted to be working with North East London Cancer Alliance to optimise its radiology workflow and diagnostic lung cancer pathway with AI. Identifying suspicious signs of lung cancer such as nodules or masses on chest X-rays will help move patients into the next step of the diagnostic journey quicker, potentially improving survival with faster and earlier diagnosis.”

“This commercial deployment is a true partnership of AI activation, working closely with the Alliance, its hospitals and Sectra, to balance clinical considerations, information governance, AI integration into existing healthcare IT systems. Once live, as an AI partner, we move onto user training and patient awareness,” she adds.

Chris Scarisbrick, Customer Operations Director and Deputy Managing Director at Sectra UK says "At Sectra, we are proud to see the successful deployment of our Amplifier Service alongside the Qure.ai qXR AI application within the North East London Cancer Alliance. Our service's marketplace and open approach to application integration streamlines AI adoption, embedding it seamlessly into radiology workflows.

“This collaboration showcases how a fully integrated AI-driven workflow can transform diagnostic efficiency. By seamlessly embedding AI into existing radiology pathways, we ensure that urgent cases are prioritised swiftly, helping to reduce reporting delays and improve patient outcomes. This is a key step in optimising clinical resources and providing faster, more accurate diagnoses, all while maintaining a seamless experience for healthcare providers."

For more information

About use of AI in Healthcare settings: It is important to note that the use of this AI tool complies with Article A22 of the GDPR, as all chest x-rays are ultimately reviewed and reported by a qualified human radiologist. The AI is used purely as a supportive tool, not to make any final decisions on its own.

North East London Cancer Alliance is also proud to be one of 11 imaging networks nationally participating in an NHS England in-service evaluation, in line with the NICE EVA (Evidence Standards Framework for Evaluation) recommendations. This ensures the technology is rigorously assessed and used in accordance with national best practice standards.

Additionally, the AI technology used has received the requisite MHRA (Medicines and Healthcare products Regulatory Agency) approval for commercial deployment in the UK. It has attained the highest level of clearance under CE II MDR, classified as Class IIb software (Medical Device Regulation), meaning it meets stringent safety and performance standards for medical devices.

About Qure.ai: Qure.ai is a health tech company that uses deep learning and AI to make healthcare more accessible and equitable for patients worldwide. Their solutions power the efficient identification and management of Tuberculosis (TB), Lung Cancer and Stroke to support clinicians and propel developments in the pharmaceutical and medical device industries. They empower healthcare by helping to identify conditions fast, prioritize treatment planning and ultimately improve quality of patient life.   

About Sectra: With over 30 years of innovation and more than 2,500 installations around the globe, Sectra is a leading imaging IT provider to health systems worldwide. Sectra offers a complete enterprise solution comprised of imaging modules (radiology, cardiology, pathology, orthopedics, and ophthalmology), and a robust VNA. Over the last consecutive eleven years, Sectra has been awarded Best in KLAS for highest customer satisfaction. Sectra Amplifier Service is the single point of coordination for contracting, purchasing, and servicing of AI applications, validated and verified for use at point of care. It provides you with a marketplace to browse and buy applications and a cloud-based platform to host them.