A Roadmap for Foundational Research on Artificial Intelligence in Medical Imaging: From the 2018 NIH/RSNA/ACR/The Academy Workshop
Open accessAbstract
Imaging research laboratories are rapidly creating machine learning systems that achieve expert human performance using open-source methods and tools. These artificial intelligence systems are being developed to improve medical image reconstruction, noise reduction, quality assurance, triage, segmentation, computer-aided detection, computer-aided classification, and radiogenomics. In August 2018, a meeting was held in Bethesda, Maryland, at the National Institutes of Health to discuss the current state of the art and knowledge gaps and to develop a roadmap for future research initiatives. Key research priorities include: 1, new image reconstruction methods that efficiently produce images suitable for human interpretation from source data; 2, automated image labeling and annotation methods, including information extraction from the imaging report, electronic phenotyping, and prospective structured image reporting; 3, new machine learning methods for clinical imaging data, such as tailored, pretrained model architectures, and federated machine learning methods; 4, machine learning methods that can explain the advice they provide to human users (so-called explainable artificial intelligence); and 5, validated methods for image de-identification and data sharing to facilitate wide availability of clinical imaging data sets. This research roadmap is intended to identify and prioritize these needs for academic research laboratories, funding agencies, professional societies, and industry.
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Interobserver and intraobserver variability of CT image interpretations rendered by radiologists can be as high as 37%.
“The problem is exacerbated by issues related to interobserver and intraobserver variability of CT image interpretations rendered by radiologists, which can be as high as 37%.206”
From Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review (2021) · cites this paper as [206]
The Introduction states that inter- and intraobserver variability can reach 37%, depending on imaging modality. It does not establish that this rate applies to CT interpretations specifically; the cited reference (17) concerns mammograms. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe drop in ImageNet error rate below 5% was largely due to advances in deep learning.
“This was largely due to advances in deep learning, the branch of AI that learns from large amounts of data.”
From Introduction to artificial intelligence in ultrasound imaging in obstetrics and gynecology (2020) · cites this paper as [17]
In 2015, the ImageNet annual competition reached a milestone when the error rate of automatic classification of images dropped below 5%, which is the average human error rate.
“In 2015, the ImageNet annual competition reached a milestone when the error rate of automatic classification of images dropped below 5%, which is the average human error rate (Figure S1) 17 .”
From Introduction to artificial intelligence in ultrasound imaging in obstetrics and gynecology (2020) · cites this paper as [17]
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Maior, C. B. S., Santana, J. M., Lins, I. D., & Moura, M. J. C. (2021) · PLoS ONE · doi:10.1371/journal.pone.0247839 · Cited by 42 · see citing works
Understanding artificial intelligence based radiology studies: CNN architecture
Mutasa, S., Sun, S. H., & Ha, R. S. (2021) · Clinical Imaging · doi:10.1016/j.clinimag.2021.06.033 · Cited by 40 · see citing works
AI musculoskeletal clinical applications: how can AI increase my day-to-day efficiency?
Shin, Y., Kim, S., & Lee, Y. (2021) · Skeletal Radiology · doi:10.1007/s00256-021-03876-8 · Cited by 36 · see citing works
Olawade, D. B., Marinze, S., Qureshi, N., Weerasinghe, K., & Teke, J. (2025) · Current Research in Translational Medicine · doi:10.1016/j.retram.2025.103493 · Cited by 39 · see citing works
Polygenic Risk Score for Cardiovascular Diseases in Artificial Intelligence Paradigm: A Review
Khanna, N. N., Singh, M., Maindarkar, M. A., Kumar, A., Johri, A. M., Mantella, L. E., Laird, J. R., Paraskevas, K. I., Ruzsa, Z., Singh, N., et al. (2023) · Journal of Korean Medical Science · doi:10.3346/jkms.2023.38.e395 · Cited by 36 · see citing works
Deep Learning for Underwater Visual Odometry Estimation
Teixeira, B., Silva, H., Matos, A., & Silva, E. (2020) · IEEE Access · doi:10.1109/access.2020.2978406 · Cited by 31 · see citing works
Wong, C. W., & Chaudhry, A. A. (2020) · Journal of Thoracic Disease · doi:10.21037/jtd-2019-pitd-10 · Cited by 35 · see citing works
Handling data heterogeneity with generative replay in collaborative learning for medical imaging
Qu, L., Balachandar, N., Zhang, M., & Rubin, D. L. (2022) · Medical Image Analysis · doi:10.1016/j.media.2022.102424 · Cited by 35 · see citing works
A blockchain-based protocol for tracking user access to shared medical imaging
de Aguiar, E. J., dos Santos, A. J., Meneguette, R. I., Grande, R. E. D., & Ueyama, J. (2022) · Future Generation Computer Systems · doi:10.1016/j.future.2022.04.017 · Cited by 34 · see citing works
The Role of Artificial Intelligence in the Identification and Evaluation of Bone Fractures
Tieu, A., Kroen, E., Kadish, Y., Liu, Z., Patel, N. R., Zhou, A., Yilmaz, A., Lee, S., & Deyer, T. W. (2024) · Bioengineering · doi:10.3390/bioengineering11040338 · Cited by 36 · see citing works
Gleeson, F. V., Revel, M., Biederer, J., Larici, A. R., Martini, K., Frauenfelder, T., Screaton, N. J., Prosch, H., Snoeckx, A., Sverzellati, N., et al. (2023) · European Radiology · doi:10.1007/s00330-023-09409-2 · Cited by 34 · see citing works
The potential of AI in cancer care and research
Sharpless, N. E., & Kerlavage, A. R. (2021) · Biochimica et Biophysica Acta (BBA) - Reviews on Cancer · doi:10.1016/j.bbcan.2021.188573 · Cited by 32 · see citing works
Wehrend, J., Silosky, M. S., Xing, F., & Chin, B. B. (2021) · EJNMMI Research · doi:10.1186/s13550-021-00839-x · Cited by 32 · see citing works
Advancing Medical Imaging Research Through Standardization
Jeon, K., Park, W. Y., Kahn, C. E., Nagy, P. G., You, S. C., & Yoon, S. H. (2024) · Investigative Radiology · doi:10.1097/rli.0000000000001106 · Cited by 31 · see citing works
- Authors
- Langlotz, C. P., Allen, B., Erickson, B. J., Kalpathy-Cramer, J., Bigelow, K., Cook, T. S., Flanders, A. E., Lungren, M. P., Mendelson, D. S., Rudie, J. D., Wang, G., & Kandarpa, K.
- Affiliations
- Mayo Clinic (US)
- National Institutes of Health (US)
- ORCID
- Venue
- Radiology
- Published
- 2019-06
- Volume
- 291
- Issue
- 3
- Pages
- 781-791
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- PMC
- PMC6542624
- OpenAlex
- W2939071985
- Cited by
- 368
- References
- 85
- Citations by year
- 2026: 34 · 2025: 33 · 2024: 45 · 2023: 57 · 2022: 56 · 2021: 68 · 2020: 58 · 2019: 17
- FWCI
- 15.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Radiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Biomedical Imaging and Bioengineering
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
- Keywords
- artificial intelligence in medical imaging, research priorities, image reconstruction, image segmentation, computer-aided detection, computer-aided classification, radiogenomics, automatic image annotation, electronic phenotyping, federated learning, pre-trained models, explainable AI
- MeSH terms
- Machine Learning, Algorithms, Artificial Intelligence, Diagnostic Imaging, Humans, Image Interpretation, Computer-Assisted, Biomedical Research
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