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Findings from the landmark Articulate Pro study have now been published, marking a major milestone for the use of artificial intelligence (AI) in NHS histopathology laboratories and demonstrating its potential to improve and standardise prostate cancer diagnosis.

Professor Clare Verrill uses the new AI pathology software
Professor Clare Verrill uses the AI pathology software

Led by Professor Clare Verrill at the University of Oxford’s Nuffield Department of Surgical Sciences, the study is one of the first examples of real time use of AI technology in NHS histopathology practice. It provides new evidence that AI can be safely and effectively incorporated within routine diagnostic workflows. 

The technology, Paige Prostate, was evaluated in the prostate cancer biopsy pathway across three NHS trusts in the UK. The aim was to assess whether the AI diagnostic system could support more consistent and accurate diagnosis. 

The Paige Prostate Suite is a group of AI-powered applications designed to aid in the detection and grading of prostate cancer on routine stained images of prostate needle biopsies. The study examined how using the Paige Prostate Suite impacted pathologists’ clinical decision-making, pathology service delivery, and use of resources in real-world NHS setting.

The study – called ‘Articulate Pro: Artificial Intelligence for Cellular Pathology Transformation in Prostate Practice’ – was delivered by a multi-disciplinary team, and the technology was rolled out for evaluation at Oxford University Hospitals NHS Foundation Trust, North Bristol NHS Trust, and University Hospitals Coventry and Warwickshire NHS Trust.

More than 1,000 men’s prostate biopsies were assessed in real time, with AI used alongside expert histopathologists. The study demonstrated that the technology could be safely deployed in NHS IT systems, identifying areas suspected of being cancerous that were difficult to spot, or resulting in an amended grade (aggressiveness); in a small number of cases, this led to different clinical management options being offered. Quicker turnaround of reporting was seen in some centres meaning that patients could potentially receive results a day sooner than without this technology. A reduction in immunohistochemistry (IHC) requests, for extra staining, has also been demonstrated. This could consequently benefit overstretched NHS labs by reducing workflow and generating cost savings.

Individuals with lived experience of prostate cancer contributed at every stage, and three members of the public served on the Project Management Board.

Clare Verrill, lead author and Professor of Cellular Pathology and AI, said: ‘This study provides vital evidence that we can safely and effectively roll out AI technology to help improve prostate cancer diagnosis in the NHS, working alongside expert histopathologists. This helps realise the vision of digitally enabled healthcare for all, which will pave the way for large scale uptake across the NHS.’

The study was funded and overseen by the Department of Health and Social Care (DHSC), in collaboration with the National Institute for Health and Care Research (NIHR) and the Accelerated Access Collaborative (AAC), through the Artificial Intelligence in Health and Care Awards.

The paper, ‘An evaluation of artificial intelligence assisted prostate biopsy reporting in the Articulate Pro study’, is published in NPJ Digital Medicine.