Real World Evaluation of Lunit INSIGHT MMG Technology

Lunit

Status: Not yet enrolling

Conditions: Breast Cancer; Breast Diseases

Treatments: Device: Lunit INSIGHT MMG

Study type: Observational

Funder types: Other; Industry

Identifiers

NCT06232070

Lunit INSIGHT protocol

Details and patient eligibility

About

This study is a single-centre prospective observational cohort study designed to assess and compare the sensitivity and specificity of a Lunit INSIGHT MMG assisted human reading to the standard care double human reading process within mammography review at a "one-stop" breast clinic (non-inferiority study).

The current imaging reporting process is a sequential double read of mammography and ultrasound (if available) images, by consultant radiologists or radiographers. The first reader produces a report which is then sent to the second reader who reviews it. If the second reader agrees with the first, this is reflected in the second reader's report which translates into a decision for further action; in the event of disagreement, a third reader arbitrates and produces the final report.

In the past, breast clinics have had to resort to single reader reporting due to staff shortages and high demand. This results in delays to any further assessments that may be required. It is worth noting however that despite difficulties in meeting the target, the current clinical pathway has proven to be cost effective.

The Lunit INSIGHT MMG tool could generate benefits and potential efficiencies if it were introduced to the clinical service as an assistant reader within the mammography reporting process, by replacing one of the two human readers in the current standard of care. Before this can be assessed however, its non-inferiority in combination with a human reader in comparison to standard of care (double human reading) must first be established. This study will aim to address this issue in the first instance, maintaining standard of care for all patients seen within the 2 week wait pathway, by introducing the use of Lunit INSIGHT MMG into one of two arms within this prospective, observational parallel cohort study.

Full description

The study has three main objectives, which will be met through separate sub-studies and analyses.

First, it will investigate and compare the performance of the Lunit INSIGHT MMG tool in combination with a human reader, against the current standard of care (two human readers). Quantitative data will be collected from a prospective, observational cohort study which will take place during routine clinical care at the participating site in parallel to standard care. The main aims will be:

To assess and compare the sensitivity and specificity of Lunit INSIGHT MMG combined with a single human reader for non-inferiority compared to double human reading To assess and compare the rate of escalation to arbitration (following non-agreement) for non-inferiority of Lunit INSIGHT MMG combined with a single human reader against double human reading To assess clinician reported agreement with the Lunit INSIGHT MMG report To address any differences in performance characteristics as a function of patient age 6 To assess how Lunit score relates to tumour grade on biopsy

Second, the acceptability and perceptions surrounding the AI will be investigated using qualitative data obtained from patient and workforce interviews and questionnaires from the latter. The main aims will be to assess the acceptability of the Lunit INSIGHT MMG tool to patients and the workforce and explore patient and workforce perceptions surrounding it and its implementation in clinical pathways.

Third, a health economic evaluation will be carried out in a cost effectiveness analysis to assess the value of introducing the Lunit INSIGHT MMG tool at a "one-stop" breast clinic. The main aims will be two. The implementation costs of the Lunit Insight MMG tool and costs of a scan read by it, in combination with a human reader, will be compared against the cost of double human readings based on standard practices. In addition, a valuation of outcomes will also be undertaken following the lifetime of the cohort with the use of the Lunit INSIGHT MMG tool compared with standard of care.

Enrollment: 5,500 estimated patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Non-Inferiority Study

• Women 18 years of age or older.
• Referred to a "one-stop" breast clinic following GP appointment for breast symptoms.

Patient and workforce qualitative studies Patients: as above. Workforce: Clinical staff and other key stakeholders involved in the implementation of Lunit INSIGHT MMG both male and female

• Able to undergo mammography.

Exclusion criteria

Non-Inferiority Study

• Men will not be included in this study.
• Women who are not able to tolerate a mammogram or are unable to have one due to physical difficulties in engagement with the technology caused by immobility or being wheelchair bound.

Patient and workforce qualitative studies Patients: as above. Workforce: Has no connection to Lunit INSIGHT MMG implementation irrespective of being male or female

Trial design

5,500 participants in 2 patient groups

Standard Pathway Arm

Description:

All participating patients will have their mammograms reported using the standard of care. The mammograms randomised to the Standard Pathway arm will be reported using the current standard of care, which involves two human readers; The readers will be blind to Lunit INSIGHT MMG report

Lunit Assisted Arm

Description:

All participating patients will have their mammograms reported using the standard of care. Those randomised to the Lunit assisted arm will also undergo double reader process , ensuring the current standard of clinical care is provided. In addition to that, the Lunit INSIGHT MMG report will also be available to the readers. Within this arm, each reader will be presented with a Likert scale to rank their level of agreement with the Lunit INSIGHT MMG report

Treatment:

Device: Lunit INSIGHT MMG