Slovakia has deployed a nationwide artificial intelligence solution that automatically contours structures on planning CT scans in radiotherapy. Thanks to public procurement with a strong emphasis on quality, it has shortened specialists’ work and standardized practice across centers. The project runs safely on‑premise and creates conditions for further automation of treatment.
Why radiotherapy, and where AI helps
Approximately 30,000 oncology cases are diagnosed in Slovakia each year, and about 12,000 patients need radiotherapy. A key step in treatment planning is precisely drawing the tumor site and the surrounding healthy tissues on the planning CT. Until now, radiation oncologists did this manually, which, depending on complexity, took 10 to 90 minutes, and for complex head and neck sites on the order of hours.
AI can now contour 50 to 60 healthy structures in under five minutes, whereas manually only a few of the most important were often drawn. A physician then quickly reviews and, if needed, adjusts the output, saving time for work that adds value for the patient. Better and more consistent contours enable medical physicists to plan radiation doses more precisely so that healthy tissues are spared and treatment toxicity is reduced.
Procurement focused on quality, not just price
A project funded from the Recovery Plan was preceded by preliminary market consultations to verify the safety and benefits of available certified solutions. In the public procurement, quality accounted for as much as 50 percent, of which 40 percent consisted of expert evaluation of outputs from an anonymized set of CT images. Three radiation oncologists, women or men, with more than 10 years of experience compared the applicants’ results; the scope of structures, functionality, and the degree of process automation were also assessed.
International suppliers from the EU and the USA took part in the competition, and an electronic auction was held at the end. It reduced the price by more than 60 percent compared to the estimated contract value, while maintaining the focus on quality and safety. An important factor in success was the collaboration between the ministry, expert guarantors, and vendors throughout the entire preparation and implementation.
Deployment, data security, and next steps
The solution was installed last year at almost all Slovak radiotherapy sites, so it is available to all radiotherapy patients. Implementation was completed in 27 days at ten sites, thanks in part to the Slovak partner’s many years of integration practice and the U.S. AI vendor Rad Formation. The nationwide rollout unified contouring quality in line with international recommendations and created the basis for benchmarking across centers.
Operation is on‑premise: CT images are processed within the hospital network, data are transmitted in anonymized form, and personal identifiers are minimized. Emphasis on integration and cybersecurity remains key, as does ongoing physician training and strengthened quality assurance by medical physicists. Thanks to standardized outputs, it is already possible to script parts of planning, and fuller automated planning is within reach, which will further free up team capacity.
