AI in imaging: the regulatory landscape
Open accessAbstract
Artificial intelligence (AI) methods have been applied to medical imaging for several decades, but in the last few years, the number of publications and the number of AI-enabled medical devices coming on the market have significantly increased. While some AI-enabled approaches are proving very valuable, systematic reviews of the AI imaging field identify significant weaknesses in a significant proportion of the literature. Medical device regulators have recently become more proactive in publishing guidance documents and recognizing standards that will require that the development and validation of AI-enabled medical devices need to be more rigorous than required for tradition “rule-based” software. In particular, developers are required to better identify and mitigate risks (such as bias) that arise in AI-enabled devices, and to ensure that the devices are validated in a realistic clinical setting to ensure their output is clinically meaningful. While this evolving regulatory landscape will mean that device developers will take longer to bring novel AI-based medical imaging devices to market, such additional rigour is necessary to address existing weaknesses in the field and ensure that patients and healthcare professionals can trust AI-enabled devices. There would also be benefits in the academic community taking into account this regulatory framework, to improve the quality of the literature and make it easier for academically developed AI tools to make the transition to medical devices that impact healthcare.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Social bias arises from societal inequalities and prejudices embedded in the data.
“Social bias arises from societal inequalities and prejudices embedded in the data [13,29,48].”
From Frameworks encompassing intersectional perspective of artificial intelligence in healthcare. Scoping review (2026) · cites this paper as [48]
The Discussion’s Bias section says imaging datasets can be demographically skewed and describes potential ethnic and socio-economic biases that may hamper generalization. That supports the data-bias aspect of the claim, but the paper does not specifically say those biases arise from societal inequalities or prejudices embedded in the data. No page number is available in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Wynants, L., Van Calster, B., Bonten, M. M., Collins, G. S., Debray, T. P., De Vos, M., Haller, M. C., Heinze, G., Moons, K. G., Riley, R. D., et al. (2020) · doi:10.1101/2020.03.24.20041020 · Cited by 3,070 · see citing works
Lotter, W., Diab, A. R., Haslam, B., Kim, J. G., Grisot, G., Wu, E., Wu, K., Onieva, J. O., Boyer, Y., Boxerman, J. L., et al. (2021) · Nature Medicine · doi:10.1038/s41591-020-01174-9 · Cited by 423 · see citing works
Dhiman, P., Ma, J., Andaur Navarro, C. L., Speich, B., Bullock, G., Damen, J. A. A., Hooft, L., Kirtley, S., Riley, R. D., Van Calster, B., et al. (2022) · BMC Medical Research Methodology · doi:10.1186/s12874-022-01577-x · Cited by 140 · see citing works
Automatic segmentation of the right ventricle from cardiac MRI using a learning‐based approach
Avendi, M. R., Kheradvar, A., & Jafarkhani, H. (2017) · Magnetic Resonance in Medicine · doi:10.1002/mrm.26631 · Cited by 135 · see citing works
Generative AI for brain image computing and brain network computing: a review
Gong, C., Jing, C., Chen, X., Pun, C. M., Huang, G., Saha, A., Nieuwoudt, M., Li, H.-X., Hu, Y., & Wang, S. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1203104 · Cited by 111 · see citing works
Flagged first, then by citations
Research works printed but not linked: 21
- [1]Kahn CE. Artificial intelligence in radiology: decision support systems. Radiographics. 1994; 14(4): 849- 861. 7938772
- [2]Scott R. Artificial intelligence: its use in medical diagnosis. J Nucl Med. 1993; 134(3): 510- 514. 8441047
- [3]Woods W, Uckun S, Kohane I, et al AAAI 1994 Spring Symposium Series Reports. AI Mag. 1994; 15(3): 22- 22.
- [4]Muehlematter UJ, Bluethgen C, Vokinger KN. FDA-cleared artificial intelligence and machine learning-based medical devices and their 510(k) predicate networks. Lancet Digit Health. 2023; 5(9): e618- e626. 37625896
- [7]Barragán-Montero A, Javaid U, Valdés G, et al Artificial intelligence and machine learning for medical imaging: a technology review. Phys Med. 2021; 83: 242- 256. 33979715 PMC8184621
- [8]Gilson A, Safranek CW, Huang T, et al How does ChatGPT perform on the United States Medical Licensing Examination? The implications of large language models for medical education and knowledge assessment. JMIR Med Educ. 2023; 9: e45312. 36753318 PMC9947764
- [11]Perez AA, Noe-Kim V, Lubner MG, et al Deep learning CT-based quantitative visualization tool for liver volume estimation: defining normal and hepatomegaly. Radiology. 2021; 302(2): 336- 342. 34698566 PMC8805660
- [12]Balboni E, Nocetti L, Carbone C, et al The impact of transfer learning on 3D deep learning convolutional neural network segmentation of the hippocampus in mild cognitive impairment and Alzheimer disease subjects. Hum Brain Mapp. 2022; 43(11): 3427- 3438. 35373881 PMC9248306
- [13]Ranjbarzadeh R, Dorosti S, Jafarzadeh Ghoushchi S, et al Breast tumor localization and segmentation using machine learning techniques: overview of datasets, findings, and methods. Comput Biol Med. 2023; 152: 106443. 36563539
- [14]van Kempen EJ, Post M, Mannil M, et al Performance of machine learning algorithms for glioma segmentation of brain MRI: a systematic literature review and meta-analysis. Eur Radiol. 2021; 31(12): 9638- 9653. 34019128 PMC8589805
- [15]Bischoff LM, Peeters JM, Weinhold L, et al Deep learning super-resolution reconstruction for fast and motion-robust T2-weighted prostate MRI. Radiology. 2023; 308(3): e230427. 37750774
- [16]Popuri K, Ma D, Wang L, Beg MF. Using machine learning to quantify structural MRI neurodegeneration patterns of Alzheimer’s disease into dementia score: independent validation on 8,834 images from ADNI, AIBL, OASIS, and MIRIAD databases. Hum Brain Mapp. 2020; 241(14): 4127- 4147. PMC7469784 32614505
- [17]Jabal MS, Joly O, Kallmes D, et al Interpretable machine learning modeling for ischemic stroke outcome prediction. Front Neurol. 2022; 13: 884693. 35665041 PMC9160988
- [21]Brugnara G, Baumgartner M, Scholze ED, et al Deep-learning based detection of vessel occlusions on CT-angiography in patients with suspected acute ischemic stroke. Nat Commun. 2023; 14(1): 4938. 37582829 PMC10427649
- [22]Lind Plesner L, Müller FC, Brejnebøl MW, et al Commercially available chest radiograph AI tools for detecting airspace disease, pneumothorax, and pleural effusion. Radiology. 2023; 308(3): e231236. 37750768
- [23]Kelly BS, Judge C, Bollard SM, et al Radiology artificial intelligence: a systematic review and evaluation of methods (RAISE). Eur Radiol. 2022; 32(11): 7998- 8007. 35420305 PMC9668941
- [24]Grewal H, Dhillon G, Monga V, et al Radiology gets chatty: the ChatGPT saga unfolds. Cureus. 15(6): e40135. 37425598 PMC10329466
- [25]Borchert RJ, Azevedo T, Badhwar A, et al Deep Dementia Phenotyping (DEMON) Network Artificial intelligence for diagnostic and prognostic neuroimaging in dementia: a systematic review. Alzheimers Dement. 2023; 19(12): 5885- 5904. 37563912
- [28]Petrick N, Chen W, Delfino JG, et al Regulatory considerations for medical imaging AI/ML devices in the United States: concepts and challenges. J Med Imaging (Bellingham). 2023; 10(5): 051804. 37361549 PMC10289177
- [34]Fry A, Littlejohns TJ, Sudlow C, et al Comparison of sociodemographic and health-related characteristics of UK biobank participants with those of the general population. Am J Epidemiol. 2017; 186(9): 1026- 1034. 28641372 PMC5860371
- [35]Chan HP, Samala RK, Hadjiiski LM. CAD and AI for breast cancer-recent development and challenges. Br J Radiol. 2020; 93(1108): 20190580. 31742424 PMC7362917
Cited by
Sorted by citations
Amaya-Santos, S., Vargas, C., & Bermúdez-Tamayo, C. (2026) · Public Health in Practice · doi:10.1016/j.puhip.2025.100713 · Cited by 4 · see citing works
“Social bias arises from societal inequalities and prejudices embedded in the data [13,29,48].”
- Authors
- Hill, D. L. G.
- Affiliations
- UCL , Gower Street , London, WC1E 6BT, United Kingdom
- ORCID
- Hill, Derek L G
- Venue
- British Journal of Radiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2024-01-04
- Volume
- 97
- Issue
- 1155
- Pages
- 483-491
- ISSN
- 0007-1285 (ISSN-L)
- 1748-880X
- PMC
- PMC11027239
- OpenAlex
- W4390590287
- Cited by
- 52
- References
- 5
- Citations by year
- 2026: 23 · 2025: 24 · 2024: 5
- FWCI
- 4.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Radiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Health Professions › Health Information Management › Healthcare Regulation
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Safety Systems Engineering in Autonomy
- Keywords
- artificial intelligence, diagnostic imaging, regulatory guidelines, AI-enabled medical devices, device validation, risk mitigation, algorithmic bias, clinical meaningfulness, regulatory standards
- MeSH terms
- Artificial Intelligence, Health Personnel, Humans, Publishing, Software
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review