Gerald Lip, NHS Grampian reviewing a Mammogram

NHS Grampian is working with Kheiron Medical Technologies, University of Aberdeen and Microsoft to support breast cancer detection

NHS Grampian, which provides health and social care services to more than 500,000 people in Scotland, is trialling Kheiron Medical Technologies’ artificial intelligence to help medical staff detect cancer, cut the backlog of mammograms to be read and deliver results to patients faster.

More than two million women have a breast cancer screening each year in the UK. As a result of the COVID-19 pandemic, staff pressures and long waiting lists, there is a backlog of mammograms to be read.

The detection of breast cancer can be difficult with an incidence of 6 in 1000 women which is why in the UK and in Europe, two specialists read every mammogram. This ensures the majority of cancers are detected at screening. Occasionally, cancers are missed at or occur after screening. These are known as interval cancers.

NHS Grampian, which serves the public in Aberdeen, Aberdeenshire and Moray, is evaluating Kheiron Medical Technologies’ AI solution  Mia®, which is supported by Microsoft’s Azure Cloud.  The Trust aims to demonstrate that using an AI alongside a highly trained radiologist will deliver a reduction in the time people have to wait for screening results, an increase in the detection of breast cancers and also reduce pressure on the screening service.

Evidence of success

Under an Innovate UK funded programme, the Industrial Centre for Artificial Intelligence Research in Digital Diagnostics (iCAIRD), Gerald Lip, Lead Radiologist at NHS Grampian, and Professor Lesley Anderson, Chair in Health Data Science, University of Aberdeen led a research team reviewing Mia’s performance on historical mammograms. Partnering with Kheiron in iCAIRD, the team ran Mia on deidentified scans with known outcomes from a previous 3-year screening cycle in Grampian. Over 55,000 screening events comprising more than 220,000 mammogram images were read by Mia and compared with the radiologists opinions.

Looking at a test dataset of mammograms over a 3 year period, the standard process involving two specialists would have detected 303 cancers. A single specialist reading alone, would have picked up 261 cancers and Mia reading alone would have picked up 271.  Mia also picked up a further 47 (33.8%) additional interval cancers, which would not have been detected by the two specialists.

Doctor showing text results to a patient

Dr Lip said: “We have seen significant results using Mia. Not just in the detection of difficult cancers but also in the time it takes to get results to patients. Radiologists can’t work 24 hours a day, but the AI can. By considering replacing one human review of a screening with AI we project a 30%-40% reduction in reporting workload on our team. This is time that can be spent with patients. But it’s important to remember that the AI isn’t being used in isolation. It is great at detecting breast cancer, but it is unable to review the findings in the context of past scans and medical history. This is why we are using a combination of a highly trained radiologist with the AI in all screenings.”

Jacob West, Managing Director of Healthcare and Life Sciences at Microsoft UK, said, “NHS Grampian’s work with Kheiron’s AI solution shows how cloud-based medical solutions can support the work of skilled medical professionals. Microsoft Azure is ensuring Mia has data security and privacy at its core, which is protecting patients at a time when they are at their most vulnerable. I’m excited to see the positive impact this solution will have on NHS Grampian’s patients.”

The ability to scale

Cloud technology is also helping to reach remote areas of Scotland. The North East of Scotland Service is able to take a mobile mammogram unit across remote locations, Orkney and Shetland islands and securely transfer all images via the cloud to its centre. In the North East of Scotland, this is up to 10,000 women a year. Mia could potentially read these scans quickly before they are shared with the radiologists on duty.

The joint Microsoft and Kheiron Medical solution fully deidentifies participants data before uploading their mammogram to the Azure Cloud. Once deidentified, the Mia software reads the mammogram and sends the result back to the hospital or clinic where it is matched again with the patient’s records. Beyond NHS Grampian, this solution is currently deployed at four sites in Europe, with further deployments underway at 14 additional NHS sites in the UK. This means that more than 500,000 women a year could be screened by Mia.

“The Mia/Azure solution can detect cancers that are sometimes missed by radiologists, because it’s such a difficult task,” says Dr Peter Kecskemethy, CEO of Kheiron. “That’s many people who now have a better chance of their cancer being detected early because of our work with Microsoft. Imagine if we could scale this to help millions of women? That’s exactly what we believe we can do with the global reach of the Azure Cloud.”