Perspective: NHS deployment of AI for prostate MRI demands governance and workflow focus, not just algorithm performance

Real-world AI for prostate MRI in the NHS depends more on governance, human-in-the-loop safety, and workflow integration than on algorithm validation alone. Clinical efficacy requires quality application, not just high accuracy.

• Clinical efficacy of prostate MRI AI is contingent on governance and application quality, not solely on validation metrics.
• Human-in-the-loop safety and pathway-level integration are emphasized as essential for NHS deployment.
• The perspective is informed by early implementation planning at a local general hospital.

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