Artificial intelligence helped improve consistency in prostate cancer diagnosis, shortened reporting times in some centres and reduced the need for additional laboratory tests in a real-world evaluation across three NHS trusts in the United Kingdom, according to findings from the Articulate Pro study.
The study provides some of the strongest real-world evidence to date that AI can be safely integrated into routine histopathology workflows in the National Health Service (NHS). Researchers found that the technology worked alongside expert histopathologists, rather than replacing them, while supporting diagnostic decision-making in prostate cancer biopsy assessment.
AI tested in routine prostate cancer diagnosis
The findings from the Articulate Pro study have now been published, marking a milestone in the use of artificial intelligence in NHS histopathology laboratories.
Led by Professor Clare Verrill of the University of Oxford’s Nuffield Department of Surgical Sciences, the study is among the first examples of real-time deployment of AI technology in routine NHS histopathology practice. The research evaluated whether AI could be safely and effectively incorporated into standard diagnostic workflows for prostate cancer.
The study assessed Paige Prostate, an AI diagnostic system used in the prostate cancer biopsy pathway across three NHS trusts in the UK.
The evaluation was carried out at Oxford University Hospitals NHS Foundation Trust, North Bristol NHS Trust, and University Hospitals Coventry and Warwickshire NHS Trust by a multidisciplinary team.
How the AI system works
The Paige Prostate Suite is a group of AI-powered applications designed to assist in the detection and grading of prostate cancer using routinely stained images from prostate needle biopsies.
The study, formally titled Articulate Pro: Artificial Intelligence for Cellular Pathology Transformation in Prostate Practice, examined how the AI platform influenced pathologists’ clinical decision-making, pathology service delivery and resource utilisation in a real-world NHS setting.
Artificial intelligence in pathology refers to computer systems that assist pathologists in identifying abnormalities in tissue samples. In this study, the AI system was used alongside expert histopathologists as part of the routine diagnostic workflow.
More than 1,000 prostate biopsies evaluated
Researchers assessed more than 1,000 prostate biopsy samples from men in real time, with AI working alongside expert histopathologists.
According to the study, the technology could be safely deployed within NHS IT systems. It identified areas suspected of being cancerous that were difficult to detect and, in some cases, resulted in an amended tumour grade, indicating a different level of aggressiveness. In a small number of cases, these changes led to different clinical management options being offered.
The study also found operational benefits. Some participating centres reported quicker turnaround times, allowing patients to potentially receive biopsy results a day earlier than they would without the technology.
Researchers also observed a reduction in requests for immunohistochemistry (IHC), an additional staining technique used in pathology. Lower IHC requests could reduce laboratory workload and generate cost savings for overstretched NHS histopathology services.
Public involvement built into the study
The research incorporated patient and public involvement throughout the project. Individuals with lived experience of prostate cancer contributed at every stage of the study, while three public members served on the Project Management Board.
“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,” said Professor Clare Verrill, lead author and Professor of Cellular Pathology and AI.
Government-backed evaluation
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 findings add to the growing evidence on how artificial intelligence can be incorporated into routine pathology services while maintaining the role of specialist clinicians in prostate cancer diagnosis. The researchers concluded that AI can be safely deployed within NHS histopathology laboratories to support routine diagnostic practice.
