Since its inception, the ProCAncer-I project has aimed to establish a robust, ethically compliant AI platform—ProstateNet—to revolutionize prostate cancer (PCa) care through data-driven decision support. During the implementation period (M1–M54), the consortium successfully orchestrated a multifaceted research and development program involving 36 partners across Europe.
The work began with the design of a data governance and ethical framework, securing approvals for retrospective and prospective data collection, leading to the creation of the ProstateNet image repository that maintains 14,349 unique patients, 105,443 imaging series, and 9,114,562 images. This dataset is among the largest of its kind worldwide and serves as the foundation for AI model development and/or the external validation of models already developed using other proprietary data.
Key technical developments that took place during the project implementation include, i) A standards-compliant cloud infrastructure with advanced data curation, anonymization, and data harmonization tools; ii) the development of AI models addressing distinct clinical use cases, spanning the prostate cancer care continuum, i.e. from the detection of prostate cancer with high accuracy both in peripheral and transitional zone (UC1), to the prediction of prediction of post radical prostatectomy and/or radiation-induced urinary toxicity (UC7); iii) the implementation of preprocessing pipelines and segmentation models to support AI workflows; and iv) a novel AI Model Passport system for traceability, explainability, and regulatory alignment.
Model validation was a central focus of our work. Clinical validation of selected models in a multicenter radiologist reader study demonstrated improved diagnostic performance and high user acceptance. Federated learning experiments confirmed the feasibility of decentralized, privacy-preserving model training.
In terms of dissemination, the project achieved significant visibility, with over 30 high-impact scientific publications; major presentations at ECR, EuSoMII, and AI for Health Imaging (AI4HI) cluster events; contributions to consensus guidelines like the “FUTURE-AI” framework for trustworthy AI, and active participation in standardization bodies such as OHDSI and W3C, with notable extensions to OMOP-CDM and DCAT-AP.
On the exploitation front, the project finalized a two-phase sustainability plan. In the short term, a FORTH-led four-year roadmap will maintain the infrastructure. For long-term sustainability, ProstateNet will be integrated into the EUCAIM platform, enabling ongoing reuse, and regulatory-grade AI development. A regulatory roadmap aligned with the EU MDR and AI Act ensures readiness for clinical deployment.
Overall, ProCAncer-I has developed a unique platform that represents a significant step toward advancing AI-enabled prostate cancer diagnostics and personalized care in Europe.
