NAVIGATOR: A regional multimodal imaging biobank initiative powered by AI tools for precision medicine in oncology

The NAVIGATOR project established an Italian regional imaging biobank and interactive research platform designed to support precision oncology through the integration of multimodal imaging, clinical, and omics data. The platform goes beyond a static repository, offering a secure Virtual Research Environment (VRE) where users can upload data, test AI algorithms, and execute complete analytical pipelines. The platform incorporates artificial intelligence (AI)-driven radiomics and deep learning methodologies to enable biomarker extraction, disease stratification, and predictive modeling. This manuscript presents the development and implementation of the NAVIGATOR infrastructure, including its data governance framework, ethical and legal considerations, and application to three oncological use cases: prostate, rectal, and gastric cancers. To date, the biobank has collected imaging and clinical data from over 700 patients across these cohorts. AI models were deployed within a dedicated VRE to facilitate image analysis, feature extraction, and classification tasks. The project addresses critical challenges related to data harmonization, regulatory compliance, privacy safeguards and fairness in AI systems. NAVIGATOR demonstrates the feasibility of integrating AI methodologies within imaging biobanks and provides a scalable framework to advance oncological research and support clinical decision-making.