An AI-enhanced chest X-ray reporting solution has begun trials in NHS Greater Glasgow and Clyde with the aim of improving early detection of lung cancer.

In the first three days of the study, almost 250 patients at three hospitals were the first to attend appointments where qXR – a collaboration between Qure.ai, NHSGGC-hosted West of Scotland Innovation Hub, the University of Glasgow and the Scottish Government – was used to analyse chest X-rays in near real-time.

Lung cancer is the most common cause of death in Scotland with around 5,500 cases diagnosed each year, predicted to increase by 29% for women and 12% for men by 2027.

By detecting cancer earlier, from GP-referred chest X-rays in an outpatient hospital setting, the patient pathway to CT scan or treatment planning can be streamlined. This will save time and potentially improve patients’ outcomes and quality of life.

The RADICAL (Radiograph Accelerated Detection and Identification of Cancer of the Lung) trial is currently under way at the Inverclyde Royal Hospital in Greenock, the Vale of Leven Hospital in Alexandria and Paisley’s Royal Alexandria Hospital. It will be widened to other NHSGGC hospitals in the coming months.

qXR is also being supported by the University of Glasgow’s Digital Health Validation Lab, part of the Living Laboratory for Precision Medicine, providing academic leadership and support to deliver the trial alongside NHSGGC and Qure.ai.

Professor David Lowe, Professor of Health Innovation at the University of Glasgow and Emergency Medicine Consultant at NHS Greater Glasgow and Clyde, said: “Worldwide healthcare systems have a significant challenge in the detection of lung cancer. At present, 40-50% of patients present with advanced or stage 4 cancer, leading to poorer outcomes. If we can spot cancer earlier, by speeding up the time and accuracy of the 100,000 chest X-rays performed each year at NHSGGC, we can improve time to further imaging, and subsequent treatment. Qure’s chest X-ray AI will help orchestrate benefits for the whole patient care pathway.”

The Qure.ai qXR solution automatically segregates ‘normal’ chest X-rays and flags abnormalities such as masses or lung nodules, enabling the prioritisation of patient case reporting for clinicians. This could potentially speed up the start of a patient’s care journey from weeks to days.

By diagnosing lung cancer earlier, at stage 2, more than 35% of patients will survive their cancer for longer than five years. This rises to more than 55% if diagnosed at stage 1. This is in stark contrast to less than 5% five-year survival at late-stage 4 diagnosis.

Denise Brown, Director of Digital Services at NHS Greater Glasgow and Clyde, said “AI is ready for adoption into clinical practice within this area of national priority. Products such as qXR from Qure.ai will help us to detect lung cancer early, this project will establish reliable evidence of impact and value, and under our Digital Strategy’s ‘Enabled by AI Programme’ is part of our ongoing work in NHS Greater Glasgow and Clyde to co-develop and adopt digital solutions that support clinical decision making.”

NHSGGC Director of Research and Innovation, Professor Julie Brittenden, said, “The West of Scotland Innovation Hub, and Department of Research & Innovation are pleased to be sponsoring and involved in delivering this study assessing the clinical effectiveness and acceptability of Qure.ai artificial intelligence software to prioritise chest X-ray (CXR) interpretation.

“Working in partnership with industry and colleagues in academia gives us many valuable opportunities to enhance our existing services and make best use of our clinical resources, and in turn provide insights that may inform treatments and practice further afield.

“Early diagnosis of cancer is of crucial importance to how we improve patient outcomes. Innovative approaches to how we can evaluate and then use AI to assist clinicians when treating their patients mean we can ensure patients are on to the appropriate treatment pathway as quickly as possible.”

Darren Stephens, Senior Vice-President & Commercial Head of UK and Europe at Qure.ai, said: “The reality of healthcare AI is exciting for us all. Diagnosing cancer and other disease conditions earlier reduces long-term pressure on the health economy, and also enhances the length and quality of life for patients. We will be closely supporting the NHS Greater Glasgow and Clyde team with this deployment,” said Darren Stephens, Senior Vice-President & Commercial Head of UK and Europe at Qure.ai.