Nine artificial intelligence technologies can be used to help
plan the treatment of those undergoing external beam radiotherapy
for cancers such as lung, prostate or colorectal, NICE has said
in draft guidance.
The move is set to speed up the time it takes to produce
"contours” or outlines of the healthy organs so that the cancer
is targeted while nearby healthy cells are avoided.
This could save money and may allow healthcare professionals to
spend more time with patients or concentrate on complex cases
when using artificial intelligence (AI) is not appropriate.
The draft guidance says all contours created by AI must still be
reviewed by a trained healthcare professional and edited as
needed before being used in radiotherapy treatment planning. A
review stage currently takes place for manual contours. Early
evidence suggests that using AI is quicker than manual contouring
even when including time for healthcare professional review and
edits.
More evidence will be generated to further check that these time
savings are realised in practice.
Evidence seen by NICE’s independent medical technologies advisory
committee suggests that AI technologies generally produce similar
quality contours of organs at risk as those carried out manually,
with most only needing minor edits.
At present following a CT or MRI scan, a radiographer would mark
up, or contour, an image by hand to highlight organs at risk of
radiation damage, lymph nodes and the site of the cancer. The
dose of radiotherapy is calculated to target the tumour site but
also to prevent organs and healthy tissue from being damaged.
The change to AI automated mark-up is not expected to affect
patient outcomes.
Clinical experts advising the independent committee estimated a
time saving of 10 minutes to 30 minutes per plan
depending on the amount of editing needed, while the clinical
evidence presented to the committee suggests it may range between
3 to 80 minutes of time saved per plan.
This is the first piece of NICE guidance to recommend the use of
AI to aid healthcare professionals in their roles.
Sarah Byron, programme director for health
technologies at NICE, said: “NHS
colleagues working on the front line in radiotherapy departments
are under severe pressure with thousands of people waiting for
scans.
“The role imaging plays in radiotherapy treatment planning is
quite pivotal, so recommending the use of AI technologies to help
support treatment planning alongside clinical oversight by a
trained healthcare professional could save both time and money.
“These technologies could decrease the time required to complete
a plan so they are able to use their expertise planning the most
complex of cases of radiotherapy or free up time to deal with
other patient-facing tasks.
“We will continue to focus on what matters most and the
recommendations made by our independent committee can help to
bring waiting lists down for those needing radiotherapy
treatment.”
Health and Social Care Secretary said: “It’s hugely
encouraging to see the first positive recommendation for AI
technologies from a NICE committee, as I’ve been clear the NHS
must embrace innovation to keep fit for the future.
“These tools have the potential to improve efficiency and save
clinicians’ thousands of hours of time that can be spent on
patient care. Smart use of tech is a key part of our NHS Long
Term Workforce Plan, and we’re establishing an expert group to
work through what skills and training NHS staff may need to make
best use of AI.”
NHS England’s radiotherapy
dataset shows that there were 134,419 radiotherapy episodes
in England in April 2021 to March 2022, of which a significant
proportion require complex treatment planning.
Technology costs ranged from £4 to £50 per plan and included
software and other associated costs including healthcare
professional training.
The possible resource benefits calculated by NICE shows that if
the lowest time saving of 3 minutes per plan is assumed and
75,000 plans are generated using AI auto-contouring the time
saved would be 3,750 hours. This would increase to 52,500 hours
for 75,000 plans and a medium time saving of 42 minutes being
assumed. At the higher end of the scale, 100,000 hours would be
saved for 75,000 plans and a time saving of 80 minutes per plan
being assumed.
Due to a lack of robust data on current practice and other
variables such as the costs and time involved, more evidence
needs to be generated over the next three years so a full
cost/benefit analysis can be carried out by NICE.
A consultation on the recommendations have now begun via
nice.org.uk and comments must be submitted by Friday 25 August
2023.
ENDS
About the technologies
The following technologies can only be used once they have
Digital Technology Assessment Criteria (DTAC) approval:
- AI-Rad Companion Organs RT (Siemens Healthineers)
- ART-Plan (TheraPanacea, Oncology Systems)
- DLCExpert (Mirada Medical)
- INTContour (Carina Medical)
- Limbus Contour (Limbus AI, AMG Medtech)
- MIM Contour ProtégéAI (MIM Software)
- MRCAT Prostate plus Auto-contouring (Philips)
- MVision Segmentation Service (MVision AI Oy, Xiel)
- RayStation (RaySearch).
About the guidance
- The draft guidance will be available at 00.01 from Friday 11
August 2023.
- An embargoed copy of the guidance is available to download.
