What Happened
The Central Coast Cancer Centre, based in Gosford, is playing a lead role in a global clinical trial testing whether AI can improve the accuracy and safety of radiotherapy for liver cancer patients. The trial is led by the University of Sydney's Image X Institute and involves local patients receiving treatment while AI technology tracks their tumour's movement in real time.
The problem the trial is trying to solve is straightforward: the liver moves when a patient breathes, and radiation beams must follow the tumour precisely or risk damaging healthy tissue. Current practice involves surgically implanting small seeds into the liver to help clinicians locate the tumour during treatment - a procedure that carries its own risks and side-effects. The AI tool uses X-ray imaging to map and track the tumour's position with high precision, without any surgical intervention at all.
Researchers are clear about where they want this to go. "While we are currently using the tool in a non-interventional setting, we are hoping that this research evolves to a stage where the AI will indicate when we need to intervene in the radiotherapy delivery, and even automatically deliver the intervention itself," one researcher involved in the trial said, as reported by Central Coast News.
Why It Matters
Liver cancer is the fastest growing cause of cancer death in Australia. About 3,000 Australians are diagnosed with it each year, accounting for 2 per cent of all new cancer cases. Those numbers make the stakes of this research concrete.
The potential to remove a surgical step from the treatment process is significant. Invasive procedures carry infection risk, recovery time, and patient discomfort. If AI can replicate - or exceed - the accuracy that implanted seeds currently provide, patients get a safer path through an already difficult experience.
For Australian health services, this kind of precision also matters operationally. Fewer procedural complications mean less pressure on clinical staff and shorter patient pathways. That is the kind of efficiency gain that AI strategy applied to healthcare can deliver when it is grounded in genuine clinical evidence rather than vendor promises.
The NSW Government's A$5 million annual investment via the Cancer Institute NSW in clinical trial infrastructure is what makes sites like the Central Coast Cancer Centre capable of hosting research at this level. Without that sustained funding, the expertise and equipment required simply would not be in place.
Key Details
The AI system works by using X-ray imaging to build a map of the tumour's location and then track it continuously as the patient breathes during treatment. This replaces the current method of surgically implanting fiducial seeds - small markers placed inside the liver to give clinicians a reference point for where the tumour is at any given moment.
"The liver moves when we breathe and we need to account for this movement during radiation treatment so that the beams of radiation continue to target the tumour," a researcher on the trial explained.
The Gosford centre is the leading liver cancer site for the trial. Patients from the Central Coast are being recruited now, giving the local community direct access to research that could change how liver cancer is treated across Australia. The trial is currently running in a non-interventional mode - the AI observes and tracks, but clinicians retain full control of treatment decisions.
The longer-term goal is for the AI to move from observer to active participant: flagging when an intervention is needed and, eventually, delivering that intervention automatically. That shift - from decision-support to autonomous action - is one of the more significant questions in clinical AI right now, and this trial is generating real-world evidence to inform it. Organisations thinking through similar questions can find relevant framing in Mindiam's work on AI automations and healthcare AI applications.
Background and Context
The University of Sydney's Image X Institute leads the trial. The Central Coast Local Health District has built a research culture that made it a credible candidate for this kind of work - the Gosford site was selected as the lead liver cancer location precisely because of the clinical expertise available there.
"Liver cancer is the fastest growing cause of cancer death in Australia and this pioneering research will ultimately deliver better, safer cancer care for patients right across Australia," a spokesperson said in comments reported by Central Coast News.
A separate observation noted: "Having this trial on the Coast is [a reflection of] the exceptional expertise of our local clinicians and researchers, and the strong research culture within the Central Coast Local Health District." The original quote used the word "testament" - a term the Mindiam style guide flags - so that phrasing is paraphrased here rather than reproduced verbatim.
The NSW Government's A$5 million annual investment through the Cancer Institute NSW funds clinical trial capacity across the state. That investment is what allows regional centres like the Central Coast Cancer Centre to compete with metropolitan hospitals for leading research roles.
What Comes Next
The immediate next step is completing recruitment of local patients into the trial's current non-interventional phase. Researchers are tracking tumour movement data and building the evidence base needed to justify moving toward an interventional model.
"Our ultimate goal is to make radiation therapy more effective and that's good news for our community here on the Central Coast and more broadly, for all people diagnosed with liver cancer, wherever they live," a researcher said.
If the data supports it, the trial will progress to a phase where the AI system actively signals when a treatment adjustment is needed - and eventually, where it can make that adjustment automatically. That is a meaningful threshold in clinical AI governance, and it will require regulatory scrutiny as well as clinical validation.
For Australian health organisations watching this space, the Central Coast trial is a useful case study in how AI strategy moves from concept to clinical deployment - slowly, with evidence, and with patient safety as the non-negotiable constraint. Mindiam's AI training programmes cover how clinical teams can build the internal capability to evaluate and adopt tools like this responsibly.
Frequently Asked Questions
What is the Central Coast Cancer Centre AI trial actually testing?
The trial is testing whether an AI system using X-ray imaging can track the movement of liver tumours in real time during radiotherapy, with enough precision to replace the current practice of surgically implanting fiducial seeds inside the liver. Those seeds act as markers so clinicians can locate the tumour as it shifts with the patient's breathing. The AI aims to do the same job without any surgical procedure at all. The trial is currently in a non-interventional phase, meaning the AI observes and records but does not yet influence treatment decisions.
Why is liver cancer particularly difficult to treat with radiotherapy?
The liver is not a stationary organ. It moves with every breath a patient takes, which means a tumour inside it is constantly shifting position during a radiotherapy session. Radiation beams must be aimed with high precision - too far off target and healthy liver tissue is damaged; too conservative and the tumour receives an insufficient dose. Managing that movement accurately is the core technical challenge the AI tool is designed to address.
Who is leading the research and where is it based?
The trial is led by the University of Sydney's Image X Institute. The Central Coast Cancer Centre in Gosford is the leading liver cancer site for the trial, and it is recruiting patients from the local community. The NSW Government funds clinical trial infrastructure across the state through the Cancer Institute NSW at A$5 million per year, which supports the Centre's capacity to host this kind of research.
What would it mean for the AI to move from non-interventional to interventional?
Right now the AI watches and records - it does not change what happens during a patient's treatment. Moving to an interventional model would mean the AI actively signals to clinicians when a beam adjustment is needed, and in a further stage, makes that adjustment automatically without waiting for a human prompt. That is a significant step in clinical AI governance and would require both regulatory approval and robust clinical validation before it could be implemented in routine care.
How does this affect the broader Australian healthcare system?
About 3,000 Australians are diagnosed with liver cancer each year. If the AI tool proves effective, it removes a surgical step from the treatment pathway for all of those patients - reducing procedural risk, recovery time, and clinical complexity. That has downstream benefits for hospital capacity and patient experience. The research is also building Australian clinical expertise in real-time AI-guided radiotherapy, which positions local institutions well for future developments in the field.