{"entity":{"id":"idea-tr1-ai-central-imaging-reads","kind":"idea","name":"AI-assisted central imaging reads to cut endpoint cost and variability","aka":[],"tldr":"Measuring tumours on scans for trials is slow, expensive and inconsistent between readers. Software that measures lesions and flags changes, checked by a radiologist, could make trial endpoints cheaper and more reliable.","summary":"Validated AI segmentation and lesion-tracking tools perform RECIST 1.1 measurements with radiologist adjudication only on flagged discordances, replacing dual blinded independent central review. Performance is locked and validated against historical BICR-adjudicated trial datasets before use; regulators accept the tool under a qualification pathway.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Trial design, endpoints and cost): Davis et al., Availability of evidence of benefits on survival and quality of life of cancer drugs approved by EMA 2009-13 (BMJ 2017)","url":"https://doi.org/10.1136/bmj.j4530"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["ct","radiology-ai-screening"],"targets":[],"drugs":[],"companies":["aidoc","lunit"],"institutions":[],"pathways":[],"terms":["recist","pfs"],"trials":[],"people":[],"bottlenecks":["b-trial-design","b-ai-validation"],"keyPapers":["paper-davis-bmj"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"AI-assisted central reads will match BICR progression dates within one assessment interval in more than 95 percent of cases, at less than half the cost and with lower inter-reader variance, without changing trial conclusions on re-analysis.","rationale":"Central imaging review is one of the largest fixed costs in phase 3 oncology trials and reader disagreement drives discordance between local and central PFS. Segmentation models now perform at expert level on common lesion types.","test":"Re-read the imaging archives of three completed phase 3 trials with the AI-assisted workflow and compare PFS hazard ratios and progression dates with the original BICR.","maturity":"early-clinical","actor":"engineering","cost":"medium","horizonYears":3},"route":"/ideas/idea-tr1-ai-central-imaging-reads/","neighbours":{"technology":[{"id":"radiology-ai-screening","kind":"technology","name":"AI in radiology","route":"/technologies/radiology-ai-screening/"},{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"}],"company":[{"id":"aidoc","kind":"company","name":"Aidoc","route":"/companies/aidoc/"},{"id":"lunit","kind":"company","name":"Lunit","route":"/companies/lunit/"}],"term":[{"id":"pfs","kind":"term","name":"Progression-free survival (PFS)","route":"/terms/pfs/"},{"id":"recist","kind":"term","name":"RECIST","route":"/terms/recist/"}],"bottleneck":[{"id":"b-ai-validation","kind":"bottleneck","name":"AI that is built but not validated or deployed","route":"/bottlenecks/b-ai-validation/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}],"paper":[{"id":"paper-davis-bmj","kind":"paper","name":"Availability of evidence of benefits on overall survival and quality of life of cancer drugs approved by European Medicines Agency: retrospective cohort study of drug approvals 2009-13","route":"/key-papers/paper-davis-bmj/"}],"roadmap":[{"id":"ai-oncology-roadmap","kind":"roadmap","name":"AI in oncology roadmap: pattern readers → foundation models → agents in the workflow","route":"/roadmaps/ai-oncology-roadmap/"},{"id":"trial-modernisation-roadmap","kind":"roadmap","name":"Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on","route":"/roadmaps/trial-modernisation-roadmap/"}]}}