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'We're at the crossroads of an exciting new world...and we are at the forefront'

06.06.23

A consultant pathologist who has pioneered the use of AI software to help diagnose prostate cancer, is spearheading another surge into what has been termed “computational pathology”.

Dr Muhammad Aslam and his colleague Dr Anu Gunavardhan have been using the programme to help diagnose breast cancers.

The application, called the Galen platform and developed by Ibex Medical Analytics, has been piloted within the health board and the team is the first in the UK to use it clinically to assist in breast cancer diagnosis.

Dr Aslam believes this new clinical use could herald the dawning of a new era in cancer diagnostics, as breast cancer treatment requires quick and accurate testing in order to get more successful outcomes for patients.

“We are at the crossroads of an exciting new world and we are at the forefront within Betsi Cadwaladr,” he said. “With the backlogs we have in the NHS it’s more important than ever to diagnose more quickly and more accurately.”

Ysbyty Gwynedd doctor recognised at national award ceremony - Betsi Cadwaladr University Health Board (nhs.wales)

In Dr Aslam’s previous trial, using it as a prostate cancer diagnostic tool, the programme looked at 1,600 biopsies and diagnosed 13% more cancers than without the AI help.

The real difference in this clinical setting is they are not only looking for the diagnostic cancer markers but also the prognosis markers, which will show which treatments or combinations of treatments will be effective for patients.

This could aid faster diagnosis of which specific cancers patients are suffering from, which in turn could inform treatment decisions more quickly.

Streamlining the system of diagnosis is paramount for the team because of the various kinds of breast cancer, which require a variety of treatments.

Dr Gunavardhan is the lead breast pathologist for BCUHB and the Quality Assurance Pathologist for Breast Test Wales. She is also chair of Welsh regional council of Royal College of Pathologists.

She said: “We need to get the results as quickly as possible, as there is lots of anxiety for the patients.

“Our national targets are to get diagnoses back in three days and decide which treatment in seven days. We have prioritised breast cancers.

“We don’t always have enough staff to give this service, so we were looking at how this programme could help us.”

Doctor urges public to protect their skin while having fun in the sun - Betsi Cadwaladr University Health Board (nhs.wales)

The Galen platform gains knowledge as it goes. Pathologists will check the suspected results for accuracy and the system learns from their input for future tests.

“It’s not difficult to diagnose cancer but then we need companion biomarkers to decide what treatment the patient gets,” Dr Gunavardhan continued.

“The biomarkers, the hormone receptors which mark the cancer, decides which treatment will be given.”

“Dr Gunavardhan’s role is to see if this AI software can help to make the process lean,” said Dr Aslam. “If the sample pathway from biopsy to definitive diagnosis with biomarkers can be shortened and made efficient, the multidisciplinary team can make the treatment decision without delay.”

Dr Aslam believes we should call it “assistive intelligence” rather than artificial intelligence because a clinician will always be needed to give the final say on diagnoses.

In the prostate cancer tests it yielded 100% reliability. When it indicated there were cancerous cells, there were, shortening the diagnostic process but, more importantly, giving assurance to pathologists they were catching as many cases as possible.

The breast project has benefited from almost £100,000 of funding from the Moondance Cancer Initiative as part of their Innovation Time Awards. The prostate project was supported by the Small Business Research Initiative Wales.

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