Artificial Intelligence in Mammography Screening in Norway

NCT ID: NCT06032390

Last Updated: 2026-01-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

150000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-25

Study Completion Date

2033-06-30

Brief Summary

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The purpose of this randomized controlled trial is to compare the number of breast cancers detected among women who had their screening mammograms interpreted by artificial intelligence (AI) in combination with one or two breast radiologists to the number of breast cancers detected after standard independent double reading in BreastScreen Norway. The aims of the study is to prove that screening interpretation with AI in combination with one or two radiologists (the intervention) is non-inferior to standard interpretation procedure.

Detailed Description

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Independent double reading with consensus is the recommended practice for breast cancer screening programs in Europe. This is a time-consuming process and more than 99% of examinations are determined to have a negative final outcome in BreastScreen Norway. However, radiologist still overlook cancers, and review-studies have shown 20-25% of screen-detected and interval cancers to be visible at prior screening mammograms. In Norway and other countries, there is also a shortage of breast radiologists.

Retrospective studies on AI in mammographic screening have shown promising results in the classification of cancer negative and cancer positive examinations. However, prospective studies are needed to elucidate questions concerning AI as a support or replacement for the radiologists in the interpretation process.

In this randomized controlled trial women attending screening and consenting to participate in the study, will be randomized (1:1 allocation) to an intervention or a control group. The screening examination will be performed as usual in both groups. The intervention in the trial is the interpretation procedure.

All examinations will be analyzed by AI. In the intervention group, examinations will be triaged according to risk of malignancy defined by an AI score. Examinations with a low AI score (1-7) will have a single reading by one radiologist and examinations with a intermediate or high AI score (8-10) will have an independent double reading by two radiologists. All examinations selected by either one or both radiologist will be discussed at consensus. Examinations with an AI raw score of \>9.8 will be discussed at consensus independent of the radiologists' interpretation. The radiologists will be blinded to whether the mammograms are interpreted by one or two radiologists. AI risk scores and AI image marking of suspicious calcifications and masses are only provided to the radiologists at consensus, not during independent reading. In the control group, two independent radiologists will interpret all screening examinations according to standard procedure, independent double reading. AI results will not be available at either independent reading or consensus, only for comparison with the intervention group in final analyses.

Screen-detected cancers in the intervention and control arm will be analyzed in terms of non-inferiority.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized to an intervention or control arm. Intervention arm will be triaged based on AI result score.
Primary Study Purpose

SCREENING

Blinding Strategy

DOUBLE

Participants Caregivers
Neither the participant nor the radiologic technician performing the mammography examination will know to what study arm the participant was allocated. Radiologists reading the screening examinations will be blinded to the intervention at initial reading but not in the consensus meeting.

Study Groups

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Intervention arm

AI assisted mammography screening interpretation

Group Type EXPERIMENTAL

AI assisted mammography screening interpretation

Intervention Type OTHER

Screening examinations will be analyzed by the AI system (Transpara, ScreenPoint Medical, Nijmegen, The Netherlands) that assigns each examination a cancer risk score 1-10. Examinations with a score 1-7 will be single read and examinations with score 8-10 will be double read. Examinations selected by one or two readers will be discussed in a consensus meeting. Examinations with an AI score of \>9.8 will be selected for the consensus meeting by default. AI risk scores and image markings are provided to the readers only in the consensus meetings. The readers will decide whether to recall the woman for further assessment in consensus (standard procedure).

Control arm

Standard mammography screening interpretation (standard procedure)

Group Type ACTIVE_COMPARATOR

Standard mammography screening interpretation

Intervention Type OTHER

Screening examinations will be assessed according to standard of care: independently double read, examinations selected by one or two readers will be discussed in a consensus meeting, and the radiologists will decide whether to recall the woman for further assessment. Screening examinations will be analyzed by the AI system retrospectively but the results will not be made available to the radiologist, only used for comparison to the intervention group in results analyses.

Interventions

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AI assisted mammography screening interpretation

Screening examinations will be analyzed by the AI system (Transpara, ScreenPoint Medical, Nijmegen, The Netherlands) that assigns each examination a cancer risk score 1-10. Examinations with a score 1-7 will be single read and examinations with score 8-10 will be double read. Examinations selected by one or two readers will be discussed in a consensus meeting. Examinations with an AI score of \>9.8 will be selected for the consensus meeting by default. AI risk scores and image markings are provided to the readers only in the consensus meetings. The readers will decide whether to recall the woman for further assessment in consensus (standard procedure).

Intervention Type OTHER

Standard mammography screening interpretation

Screening examinations will be assessed according to standard of care: independently double read, examinations selected by one or two readers will be discussed in a consensus meeting, and the radiologists will decide whether to recall the woman for further assessment. Screening examinations will be analyzed by the AI system retrospectively but the results will not be made available to the radiologist, only used for comparison to the intervention group in results analyses.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Women attending the population-based mammography screening program BreastScreen Norway providing a signed, informed consent

Exclusion Criteria

* Women attending the population-based mammography screening program BreastScreen Norway not providing a signed, informed consent
Minimum Eligible Age

50 Years

Maximum Eligible Age

69 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Helse Vest

OTHER

Sponsor Role collaborator

Helse Midt-Norge

OTHER

Sponsor Role collaborator

Helse Nord

INDUSTRY

Sponsor Role collaborator

Norwegian Cancer Society

OTHER

Sponsor Role collaborator

Norwegian Institute of Public Health

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Solveig Hofvind, PhD

Role: PRINCIPAL_INVESTIGATOR

Norwegian Institute of Public Health

Locations

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Cancer Registry of Norway, Norwegian Institute of Public Health

Oslo, , Norway

Site Status RECRUITING

Countries

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Norway

Central Contacts

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Solveig Hofvind, PhD

Role: CONTACT

22928828 ext. +47

Åsne S Holen, MSc

Role: CONTACT

Facility Contacts

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Solveig Hofvind, PhD

Role: primary

+4722928828

Other Identifiers

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366405

Identifier Type: -

Identifier Source: org_study_id

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