Data-centric artificial intelligence and cancer research: construction of a real-world head and neck treatment data repository

• Published in: ESMO Real World Data and Digital Oncology Vol. 9; p. 100162
• Main Authors: Butterworth, V., Young, T., Drake, H., Palmer, I., Avgoulea, T., Ivy, E., Andriolo, J., Creppy, C., Routledge, C., Adjogatse, D., Kong, A., Petkar, I., Reis Ferreira, M., Eaton, D., Lei, M., Misson, S., Vilic, D., Guerrero Urbano, T.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.09.2025; Elsevier
• Subjects: artificial intelligence; data; governance; infrastructure; Oncology; database; data; infrastructure; artificial intelligence; governance
• ISSN: 2949-8201; 2949-8201
• DOI: 10.1016/j.esmorw.2025.100162

The performance and generalisability of machine learning (ML) models relies on high-quality data. Retrospective and prospective collection of high-quality data for research use while respecting data protection and patient privacy remains a challenge in the clinical environment. Currently, months of laborious extraction and clinical annotation are often necessary before data analysis can begin. We present a novel institutional federated data lake, utilising open-source software, to facilitate efficient production of ML models from head and neck cancer (HNC) imaging and radiotherapy (RT) data. This structured pipeline dramatically reduces the time associated with the production of ML models and real-world evidence generation. This paper describes our governance-compliant processes and provides a framework for establishing similar databases. Extensible NeuroImaging Archival Toolkit (XNAT) is a powerful open-source imaging platform. Within our department, it forms a part of the local secure enclave for the purposes of federated learning in artificial intelligence projects and provides import, archiving, processing, search and secure distribution facilities for imaging and RT data. We have created a clinically annotated, carefully curated, data lake of 2895 consenting HNC patients containing 22 170 relevant diagnostic, staging, treatment and monitoring imaging sets. Key recommendations for replication include infrastructure planning, robust patient and data selection criteria and prioritising patient consent and privacy. This secure and extensible imaging and HNC RT cancer database setup promises to be an exceedingly useful tool for research, revolutionising the time and cost associated with the production of ML models, making the process safer, faster and more efficient. •Real-world data is critical for building predictive clinical models.•Curation of data for artificial intelligence can take months of manual work.•Patients have the right to their data being handled ethically and with respect.•We detail a database built with transparent governance and rigorous data controls.•Our secure, extensible database streamlines data access for artificial intelligence-driven research.