What is the GRACE Project?

The GRACE (Grampian’s Radiology Assisted Chest x-ray Evaluation) project sees an innovative prioritisation and decision support tool, driven by Artificial Intelligence (AI), being evaluated in radiology departments, emergency departments and acute medical assessment units across NHS Grampian.

What is the innovation?

Annalise CXR is a state of the art software-as-medical-device solution able to detect 124 clinical findings within a chest x-ray (CXR). It was developed by annalise.ai, a clinician led artificial intelligence company formed through a unique partnership between Australia’s largest medical imaging provider I-MED Radiology Network and health technology company, Harrison.ai. The Annalise CXR model was trained on over 520,000 chest x-ray studies, comprising of over 820,000 individual images. The solution was developed to assist clinicians in the prioritisation and assessment of chest x-rays for all adults over the age of 18 years of age. NHS Grampian staff were the first users of this exciting, innovative product in the UK.

Why are NHS Grampian evaluating this product?

To understand what potential impact this technology could have across the organisation, NHS Grampian rolled out Annalise CXR to a number of clinical areas to assess how the solution would perform as a decision support tool for non-specialised clinicians during out of hours, as an educational tool for junior doctors and most importantly what impact this type of AI driven solution could have on the Lung Cancer Pathway.

Shortly after implementation into the radiology department it became clear to have any real impact we needed to highlight and prioritise the clinical findings Annalise XR was identifying to the reporting team. Together with annlaise.ai and our Radiology Information System (RIS) providers NHS Grampian developed an advanced triaging tool, capable of prioritising chest x-rays with significant clinical findings and subsequently highlighting them to the team indicating that a potential suspected cancer has been detected and rapid reporting is required.

In May 2023 NHS Grampian launched their Rapid Lung Cancer Diagnostic Pathway harnessing the use of Annalise CXR and the advanced radiological triaging system to speed up the reporting of CXRs and fast tracking patient’s with suspected cancers for Computed Tomography (CT) Scanning. The pathway aims to report all CXRs with suspected pathology within 24 hours by a radiologist, and those requiring rapid CT will be scanned and reported on the same day if possible, and within 72 hours at most.

This new pathway will apply to all CXRs performed across NHS Grampian, rapidly identifying those at highest risk of lung cancer, including those where this has not been clinically suspected. We conduct about 60,000 CXRs per year in NHS Grampian. Over 6 in 10 of people with lung cancer are somewhere within this huge data set, but with no discernible clues as to where because they after not being investigated for suspected cancer.