Healthcare · Medical imaging annotation

Every label on the study is a clinical opinion.Ours come signed.

Radiology, pathology, dermatology and ophthalmology studies annotated by credential-verified clinical readers, under a task protocol agreed before the first study is opened. Two readers, a measured agreement, adjudication where they differ, and a QA record that ships with the labels.

Three questions decide whether a label set can carry a model.

A label is a clinical judgement drawn onto a study. What matters is who drew it, whether a second reader agreed, and whether the record of both survives to the audit.

  1. Who drew the line?

    Radiology reviewer · credential verified for this engagement

    Labels for a clinical model are drawn by people qualified in the modality and the task. Reader credentials are verified for the engagement, matched to the domain the study belongs to, and written into the record with every label they sign.

  2. Did a second reader agree?

    Dice 0.53 · below threshold · to adjudication

    Every study is read twice, the second reader blinded to the first and to any model proposal. Agreement is measured on the drawn structure, not assumed, and a reading below the threshold goes to a sub-specialty adjudicator instead of being averaged.

  3. Can we show the auditor?

    Task protocol TP-3 · v1.2 · label set 1.2

    The task protocol, the acceptance threshold, both readers' roles, the agreement, the route and the adjudication are logged per study. That record is part of the delivery, in the form a device or SaMD documentation review asks for.

Four annotation engagements, scoped to one modality and one task.

Each is independently purchasable and configured per engagement. Four things are settled before the first study is opened.

Agreed before the first study

  • The task protocol and the structure to be drawn
  • Who reads, and the credential verified for them
  • The acceptance threshold and the adjudication path
  • What the QA record contains
  1. Radiology annotation

    CT, MR and X-ray studies segmented, detected and classified by radiology readers.

    Segmentation, detection and classification on DICOM series, drawn by credential-verified radiology readers under your task protocol. Model proposals can be shown to the first reader and hidden from the second, so the label set measures the readers, not the model.

  2. Digital pathology annotation

    Whole-slide regions and cells outlined by pathology readers, at the magnification the task needs.

    Tumour regions, tissue classes and cell-level marks on whole-slide images, read by credential-verified pathology readers. Region boundaries are the usual source of disagreement, so adjudication is designed in from the start.

  3. Dermatology and ophthalmology annotation

    Skin lesions, fundus photographs and OCT scans labelled by readers in the specialty.

    Lesion outlines and classifications on dermoscopy and clinical photographs, disc, cup and vessel structures on fundus images, layer boundaries on OCT, read by credential-verified dermatology and ophthalmology readers.

  4. Protocol, consensus and QA design

    The task protocol, the reader roles, the threshold and the record, written before a study is opened.

    The engagement starts with the protocol: the structure to draw, the reference cases that calibrate readers, the acceptance threshold, the adjudication path and the QA record's fields. It is the document your regulatory reviewer reads first.

Scope the first set

Two readers, one label. The agreement is measured, not assumed.

Read a study yourself. You are reader 1: a model proposal is on the study, and you rule on it. Reader 2 has already read the same study blind. The overlap between your contours is computed here, in the page, and decides whether the label locks or goes to adjudication. The studies are synthetic and the geometry is a toy, so every part of the mechanism is visible.

  • The second reader is blind.

    Reader 2 never sees reader 1's contour or the model's proposal, so the agreement measures two clinical judgements, not one judgement copied.

  • The threshold is written down.

    The protocol names the agreement floor for the task. A reading below it is not averaged away; it goes to a sub-specialty adjudicator, and both contours stay in the record.

  • The record is per study.

    Reader roles, action, agreement, route, adjudication and label version are logged for every study, so a label can be traced to the people and the protocol behind it.

Task protocol TP-3 Protocol 1.2 · Label set 1.2
CT chest Axial · 1 mm · lung window
  • Model proposal
  • Reader 1
  • Reader 2
  • Label

Segment the nodule Pulmonary nodule, right upper lobe

Reader 1 · you

Radiology reviewer Credential verified for this engagement

Rule on the proposal. Reader 2 is revealed when you have drawn.

Reader 2 · blinded

Second radiology reviewer Read the study blind, before you opened it

Dice between readers none

This session

Studies read
2
Reached consensus
50%
Mean Dice
0.75
Adjudicated
1

Task protocol TP-3

Readers
Two per study, blinded to each other
Proposal
Model contour shown to reader 1 only
Acceptance
Dice at or above 0.80 between readers
Below threshold
Sub-specialty adjudicator rules; both contours kept
Record
One line per study, in the delivery
Synthetic studies and a toy geometry, so the mechanics are visible. Not patient data. Nothing on this bench is a result of ours.

The modality decides the reader.

A study is only labelled by someone qualified in its modality. Credentials are verified for the engagement, never assumed from a roster.

  1. CT, MR and X-ray Radiology reviewer Cross-sectional and plain-film studies read by a radiology reviewer, against the task protocol and the reference cases agreed for the engagement.
  2. Whole-slide images Pathology reviewer Slides read by a pathology reviewer at the magnification the task names, with region boundaries routed to adjudication when readers differ.
  3. Echo and rhythm Cardiology reviewer Echocardiography frames and rhythm strips read by a cardiology reviewer, against the clinical criteria written into the protocol.
  4. Fundus and OCT Ophthalmology reviewer Fundus photographs and OCT scans read by an ophthalmology reviewer, disc, cup, vessel and layer structures drawn to the protocol.
  5. Dermoscopy Dermatology reviewer Dermoscopy and clinical photographs read by a dermatology reviewer, lesions outlined and classified against the scheme in the protocol.

Reader roles are matched per engagement from the credentialed network, and the engagement names the readers it verifies.

The QA record, written by this session.

What an engagement delivers is not a folder of masks. It is every study with its task, its protocol version, both readers, the agreement between them, the route the label took and the version it landed in. This one is being written by what you do in the room above.

  1. MR brain · Segment the lesion core

    Adjudicated · label locked

    Reader 1 Radiology reviewer · Accepted the proposal
    Reader 2 Second radiology reviewer · Read the study blind, before you opened it
    Dice
    0.53
    Proposal vs label
    0.53
    Protocol
    Task protocol TP-3 · 1.2
    Adjudication
    Reader 2 stands
    Structure
    Lesion core, excluding surrounding oedema
    Label set
    1.1
  2. Fundus photograph · Outline the optic disc

    Consensus · label locked

    Reader 1 Radiology reviewer · Adjusted the contour
    Reader 2 Second radiology reviewer · Read the study blind, before you opened it
    Dice
    0.97
    Proposal vs label
    0.93
    Protocol
    Task protocol TP-3 · 1.2
    Adjudication
    none
    Structure
    Optic disc margin
    Label set
    1.2

Synthetic QA record · generated from this session

Start with one modality, one task, one bounded set.

A pilot is the engagement above at its smallest honest size. The protocol is written and the readers calibrated on reference cases before the first study is opened, a bounded set is read twice, and the pilot ends with a label set, its QA record and a decision. You judge it against your own model programme and your documentation review, not against a benchmark.

Fixed before the first study: the modality, the task and the structure to be drawn, who reads, and the credential verified for them, the reference cases that calibrate the readers, the acceptance threshold and the adjudication path, and what the QA record must contain.

  1. Protocol

    The task, the structure, the threshold and the record's fields, written and agreed.

  2. Calibration

    Readers read the reference cases first, so the set starts from a measured baseline.

  3. Reading

    Every study read twice, blind, with any model proposal shown to reader 1 only.

  4. Adjudication

    Readings below the threshold ruled on by a sub-specialty adjudicator, both contours kept.

  5. Delivery

    The label set, the QA record and a decision on your own criteria, ready for the next set.

The pilot ends with a label set you can trace, not a folder you have to trust.

Scope a pilot

hub Image 09 · the ribbon at rest, the single green LED (shared)

Studies are special-category data. They are handled that way.

A Norwegian company under GDPR. Imaging studies are stored in Europe by default and processed in the EEA where required, under Article 9 controls and a privacy-preserving workflow, with the paperwork to prove it. US healthcare work is handled HIPAA-compliant.

Jurisdiction
Norway · GDPR-native
Category
Article 9 special-category handling
Storage
European by default
Processing
EEA where required
Studies
DICOM de-identified before reading, where the protocol requires
Readers
Credential-verified per engagement
US engagements
HIPAA-compliant handling
Contracts
Standard DPA terms · SCCs available
Erasure
30-day end-of-contract SLA

Start with one modality, one task, one protocol.

We scope against the model the labels will train or test, write the protocol before a study is opened, and prove the method on a bounded first set.

  1. Scope
  2. Protocol
  3. Calibration
  4. First set
  5. Delivery

A bounded first set carries its own acceptance criteria and its own QA record. You judge it against your programme, not against a sample.

Briefs are treated as confidential. We are used to studies that cannot leave the EEA and programmes that cannot be named.

hub Image 10 · the bench edge, the channel as a floor line (shared)

The brief Tell us the modality, the task and what the labels will train or test. We reply with a feasibility read.

What the programme needs (optional)