Paul van Diest

UMC Utrecht

In short, Paul van Diest's research entails the following: 

Cost savings in pathology by artificial intelligence: prospective clinical trials paving the way for implementation of artificial intelligence  

'AI has shown great promise in improving speed and quality of pathology diagnostics. However, implementation of AI is yet lacking because of a problematic business case: license costs for AI algorithms on top of an expensive fully digital diagnostics workflow cannot easily be paid, requiring tangible cost savings by AI.

In this project, we run two prospective clinical trials in daily pathology practice that will, for the first time, make clear to which extent two commercially available clinical grade AI algorithms for detection of prostate cancer and metastases in breast cancer sentinel lymph nodes lead to tangible cost savings by obviating immunohistochemistry. In the control arm, cases will be reviewed as usual, applying immunohistochemistry-or-not at the discretion of the pathologist. In the intervention arm, pathologists will assess cases after the algorithm has processed these. We expect pathologists to need less immunohistochemistry to detect/reliably measure tumor load of prostate cancer and find SN metastases in breast cancer.

With the expected reduction in immunohistochemistry, we hope to show that AI implementation and running costs can be earned back in 1-2 years. These trials will help to build the business case for implementation of these AI algorithms in clinical pathology practice, and thereby close the translational gap.' 

Publications

AI helpt bij opsporen uitzaaiingen borstkanker - UMC Utrecht (Dutch only)

Clinical implementation of artificial-intelligence-assisted detection of breast cancer metastases in sentinel lymph nodes: the CONFIDENT-B single-center, non-randomized clinical trial

Brief summary of progress / results November 2023

Half way the project is running ahead of schedule. The CONFIDENT-B trial has been very successfully completed, and showed that up to 40k euros can be saved annually on immunohistochemistry of sentinel nodes at the UMC Utrecht. This has already led to full integration into the digital diagnostics workflow of the department of pathology of the UMCU, and routine use has just started.  The patient accrual for the CONFIDENT-P trial has already been completed. We expect to finish data analysis and manuscript writing in early 2024. This means that we will have time for one or more CONFIDENT trials for other organs such as testing the Visiopharm lymph node metastases app for melanoma, or lung or cervical or head&neck cancer.