The ethical adoption of artificial intelligence in radiology
Open accessAbstract
Artificial intelligence (AI) is rapidly transforming healthcare—with radiology at the pioneering forefront. To be trustfully adopted, AI needs to be lawful, ethical and robust. This article covers the different aspects of a safe and sustainable deployment of AI in radiology during: training, integration and regulation. For training, data must be appropriately valued, and deals with AI companies must be centralized. Companies must clearly define anonymization and consent, and patients must be well-informed about their data usage. Data fed into algorithms must be made AI-ready by refining, purification, digitization and centralization. Finally, data must represent various demographics. AI needs to be safely integrated with radiologists-in-the-loop: guiding forming concepts of AI solutions and supervising training and feedback. To be well-regulated, AI systems must be approved by a health authority and agreements must be made upon liability for errors, roles of supervised and unsupervised AI and fair workforce distribution (between AI and radiologists), with a renewal of policy at regular intervals. Any errors made must have a root-cause analysis, with outcomes fedback to companies to close the loop—thus enabling a dynamic best prediction system. In the distant future, AI may act autonomously with little human supervision. Ethical training and integration can ensure a "transparent" technology that will allow insight: helping us reflect on our current understanding of imaging interpretation and fill knowledge gaps, eventually moulding radiological practice. This article proposes recommendations for ethical practise that can guide a nationalized framework to build a sustainable and transparent system.
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Cites
Artificial intelligence in healthcare: past, present and future
Jiang, F., Jiang, Y., Zhi, H., Dong, Y., Li, H., Ma, S., Wang, Y., Dong, Q., Shen, H., & Wang, Y. (2017) · Stroke and Vascular Neurology · doi:10.1136/svn-2017-000101 · Cited by 4,837 · see citing works
Ehteshami Bejnordi, B., Veta, M., Johannes van Diest, P., van Ginneken, B., Karssemeijer, N., Litjens, G., van der Laak, J. A. W. M., and the CAMELYON16 Consortium, Hermsen, M., Manson, Q. F., et al. (2017) · JAMA · doi:10.1001/jama.2017.14585 · Cited by 3,293 · see citing works
Machine learning for medical imaging
Erickson, B. J., Korfiatis, P., Akkus, Z., & Kline, T. L. (2017) · RadioGraphics · doi:10.1148/rg.2017160130 · Cited by 1,672 · see citing works
Rajpurkar, P., Irvin, J., Ball, R. L., Zhu, K., Yang, B., Mehta, H., Duan, T., Ding, D., Bagul, A., Langlotz, C. P., et al. (2018) · PLOS Medicine · doi:10.1371/journal.pmed.1002686 · Cited by 1,449 · see citing works
Deep learning algorithms for detection of critical findings in head CT scans: a retrospective study
Chilamkurthy, S., Ghosh, R., Tanamala, S., Biviji, M., Campeau, N. G., Venugopal, V. K., Mahajan, V., Rao, P., & Warier, P. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31645-3 · Cited by 1,020 · see citing works
Pesapane, F., Codari, M., & Sardanelli, F. (2018) · European Radiology Experimental · doi:10.1186/s41747-018-0061-6 · Cited by 839 · see citing works
AI can be sexist and racist — it’s time to make it fair
Zou, J., & Schiebinger, L. (2018) · Nature · doi:10.1038/d41586-018-05707-8 · Cited by 765 · see citing works
The future of radiology augmented with Artificial Intelligence: A strategy for success
Liew, C. J. Y. (2018) · European Journal of Radiology · doi:10.1016/j.ejrad.2018.03.019 · Cited by 264 · see citing works
Machine Learning in Radiology: Applications Beyond Image Interpretation
Lakhani, P. C., Prater, A. B., Hutson, R. K., Andriole, K. P., Dreyer, K. J., Morey, J., Prevedello, L. M. S., Clark, T. J., Geis, J. R., Itri, J. N., et al. (2017) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2017.09.044 · Cited by 255 · see citing works
Deep learning in chest radiography: Detection of findings and presence of change
Singh, R., Kalra, M. K., Nitiwarangkul, C., Patti, J. A., Homayounieh, F., Padole, A., Rao, P., Putha, P., Muse, V. V., Sharma, A., et al. (2018) · PLOS ONE · doi:10.1371/journal.pone.0204155 · Cited by 195 · see citing works
Artificial Intelligence in Drug Discovery
Sellwood, M. A., Ahmed, M., Segler, M., & Brown, N. (2018) · Future Medicinal Chemistry · doi:10.4155/fmc-2018-0212 · Cited by 177 · see citing works
Ethics, Artificial Intelligence, and Radiology
Kohli, M. D., & Geis, J. R. (2018) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2018.05.020 · Cited by 69 · see citing works
Short history of PACS. Part I: USA
Huang, H. K. (2011) · European Journal of Radiology · doi:10.1016/j.ejrad.2010.05.007 · Cited by 47 · see citing works
Short history of PACS (Part II: Europe)
Lemke, H. U. (2011) · European Journal of Radiology · doi:10.1016/j.ejrad.2010.05.031 · Cited by 27 · see citing works
Openness and honesty when things go wrong: the professional duty of candour (GMC guideline)
Jacob, H., & Raine, J. (2016) · Archives of Disease in Childhood Education & Practice · doi:10.1136/archdischild-2015-309631 · Cited by 26 · see citing works
Simultaneous wood and metal particle detection on dark-field radiography
Braig, E., Birnbacher, L., Schaff, F., Gromann, L. B., Fingerle, A. A., Herzen, J., Rummeny, E. J., Noël, P. B., Pfeiffer, F., & Muenzel, D. (2018) · European Radiology Experimental · doi:10.1186/s41747-017-0034-1 · Cited by 21 · see citing works
The practice of radiology needs to change
Maskell, G. (2017) · BMJ · doi:10.1136/bmj.j4102 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 5
- [34]University of Oxford National Consortium of intelligent medical imaging.
- [56]Rajpurkar P, Irvin J, Bagul A, Ding D, Duan T, Mehta H. MURA: Large Dataset for Abnormality Detection in Musculoskeletal Radiographs. 2017. Available from: https://arxiv.org/abs/1712.06957. · arXiv
- [60]Medium. Machine learning and the market for intelligence conference held by creative destruction lab in Toronto. Accessed 11/08/2019.
- [79]Brown TB, Mané D, Roy A, Abadi M, Gilmer J. Adversarial Patch. 2017. Available from: https://arxiv.org/abs/1712.09665. · arXiv
- [81]Cadwalladr C, Graham-Harrison E. Revealed: 50 million Facebook profiles harvested for Cambridge Analytica in major data breach. The Observer, 2018. Available from: https://search.proquest.com/docview/2014573719.
Cited by
Sorted by citations
Secure, privacy-preserving and federated machine learning in medical imaging
Kaissis, G. A., Makowski, M. R., Rückert, D., & Braren, R. F. (2020) · Nature Machine Intelligence · doi:10.1038/s42256-020-0186-1 · Cited by 1,501 · see citing works
Current challenges of implementing artificial intelligence in medical imaging
Saw, S. N., & Ng, K. H. (2022) · Physica Medica · doi:10.1016/j.ejmp.2022.06.003 · Cited by 117 · see citing works
Ethics of AI in Radiology: A Review of Ethical and Societal Implications
Goisauf, M., & Abadía, M. C. (2022) · Frontiers in Big Data · doi:10.3389/fdata.2022.850383 · Cited by 119 · see citing works
Hickman, S. E., Baxter, G. C., & Gilbert, F. J. (2021) · British Journal of Cancer · doi:10.1038/s41416-021-01333-w · Cited by 110 · see citing works
Trustworthy Artificial Intelligence in Medical Imaging
Hasani, N., Morris, M. A., Rahmim, A., Summers, R. M., Jones, E. C., Siegel, E. L., & Saboury, B. (2021) · PET Clinics · doi:10.1016/j.cpet.2021.09.007 · Cited by 97 · see citing works
Enhancing trust in AI through industry self-governance.
Roski, J., Maier, E. J., Vigilante, K., Kane, E. A., & Matheny, M. E. (2021) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocab065 · Cited by 83 · see citing works
Eltawil, F. A., Atalla, M., Boulos, E., Amirabadi, A., & Tyrrell, P. N. (2023) · Tomography · doi:10.3390/tomography9040115 · Cited by 72 · see citing works
Atmakuru, A., Chakraborty, S., Faust, O., Salvi, M., Barua, P. D., Molinari, F., Acharya, U. R., & Homaira, N. (2024) · Expert Systems with Applications · doi:10.1016/j.eswa.2024.124665 · Cited by 61 · see citing works
Cohen, E. B., & Gordon, I. K. (2022) · Veterinary Radiology & Ultrasound · doi:10.1111/vru.13171 · Cited by 50 · see citing works
Walsh, G., Stogiannos, N., van de Venter, R., Rainey, C., Tam, W., McFadden, S. L., McNulty, J. P., Mekiš, N., Lewis, S. J., O’Regan, T., et al. (2023) · BJR|Open · doi:10.1259/bjro.20230033 · Cited by 47 · see citing works
Far, B. F. (2023) · Exploration of Targeted Anti-tumor Therapy · doi:10.37349/etat.2023.00160 · Cited by 42 · see citing works
Applications of Healthcare Robots in Combating the COVID-19 Pandemic
Raje, S., Reddy, N., Jerbi, H., Randhawa, P., Tsaramirsis, G., Shrivas, N. V., Pavlopoulou, A., Stojmenović, M., & Piromalis, D. D. (2021) · Applied Bionics and Biomechanics · doi:10.1155/2021/7099510 · Cited by 40 · see citing works
RetractedGiansanti, D. (2022) · Healthcare · doi:10.3390/healthcare10101824 · Cited by 41 · see citing works
The unintended consequences of artificial intelligence in paediatric radiology
Ciet, P., Eade, C., Ho, M., Laborie, L. B., Mahomed, N., Naidoo, J., Pace, E., Segal, B., Toso, S., Tschauner, S., et al. (2023) · Pediatric Radiology · doi:10.1007/s00247-023-05746-y · Cited by 34 · see citing works
AI and medical imaging technology: evolution, impacts, and economic insights
Buaka, E. S. D., & Moid, M. Z. I. (2024) · The Journal of Technology Transfer · doi:10.1007/s10961-024-10100-x · Cited by 32 · see citing works
Bhandari, A., Purchuri, S. N., Sharma, C., Ibrahim, M., & Prior, M. (2021) · Clinical Imaging · doi:10.1016/j.clinimag.2021.08.004 · Cited by 32 · see citing works
Lastrucci, A., Wandael, Y., Ricci, R., Maccioni, G., & Giansanti, D. (2024) · Diagnostics · doi:10.3390/diagnostics14090939 · Cited by 28 · see citing works
Belue, M. J., Harmon, S. A., Lay, N. S., Daryanani, A., Phelps, T. E., Choyke, P. L., & Turkbey, B. (2023) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2022.05.022 · Cited by 27 · see citing works
Unlocking the potential of big data and AI in medicine: insights from biobanking
Akyüz, K., Abadía, M. C., Goisauf, M., & Mayrhofer, M. T. (2024) · Frontiers in Medicine · doi:10.3389/fmed.2024.1336588 · Cited by 27 · see citing works
Blake, S. R., Das, N., Tadepalli, M., Reddy, B., Singh, A., Agrawal, R., Chattoraj, S., Shah, D., & Putha, P. (2023) · Diagnostics · doi:10.3390/diagnostics13223408 · Cited by 21 · see citing works
Self-citationBhandari, A., Scott, L., Weilbach, M., Marwah, R., & Lasocki, A. (2023) · Neuroradiology · doi:10.1007/s00234-023-03126-9 · Cited by 21 · see citing works
AI: Can It Make a Difference to the Predictive Value of Ultrasound Breast Biopsy?
Browne, J. L., Pascual, M. Á., Perez, J., Salazar, S., Valero, B., Rodriguez, I., Cassina, D., Alcázar, J. L., Guerriero, S., & Graupera, B. (2023) · Diagnostics · doi:10.3390/diagnostics13040811 · Cited by 20 · see citing works
Artificial intelligence in neuroradiology: a scoping review of some ethical challenges
Khosravi, P., & Schweitzer, M. (2023) · Frontiers in Radiology · doi:10.3389/fradi.2023.1149461 · Cited by 18 · see citing works
Khosravi, M., Zare, Z., Mojtabaeian, S. M., & Izadi, R. (2024) · Journal of Public Health · doi:10.1007/s10389-024-02219-w · Cited by 20 · see citing works
Ishibashi, K., Ariji, Y., Kuwada, C., Kimura, M., Hashimoto, K., Umemura, M., Nagao, T., & Ariji, E. (2021) · Oral Surgery Oral Medicine Oral Pathology and Oral Radiology · doi:10.1016/j.oooo.2021.08.010 · Cited by 18 · see citing works
Revolutionizing Drug Discovery With Artificial Intelligence
Barua, D. R., Das, D., & Biswas, N. (2024) · Advances in medical technologies and clinical practice book series · doi:10.4018/979-8-3693-2238-3.ch004 · Cited by 14 · see citing works
Reframing the Morbidity and Mortality Conference: The Impact of a Just Culture
Brook, K., Agarwala, A. V., & Tewfik, G. (2024) · Journal of Patient Safety · doi:10.1097/pts.0000000000001224 · Cited by 13 · see citing works
Alsharif, W. M., Qurashi, A. A., Toonsi, F. A., Alanazi, A. H., Alhazmi, F. H., Abdulaal, O. M., Aldahery, S. T., & Alshamrani, K. M. (2022) · BJR|Open · doi:10.1259/bjro.20210029 · Cited by 13 · see citing works
Martinho, D., Sobreiro, P., Domingues, A., Martinho, F. I. F., & Nogueira, N. F. R. (2026) · Healthcare · doi:10.3390/healthcare14030287 · Cited by 14 · see citing works
Odat, R. M., Marsool, M. D. M., Nguyen, D. H., Idrees, M., Hussein, A. M., Ghabally, M., Yasin, J. A., Hanifa, H., Sabet, C. J., Định, N. H., et al. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000002003 · Cited by 13 · see citing works
Balakrishnan, S., Thongprayoon, C., Wathanavasin, W., Miao, J., Mao, M. A., Craici, I. M., & Cheungpasitporn, W. (2025) · Frontiers in Artificial Intelligence · doi:10.3389/frai.2025.1525937 · Cited by 11 · see citing works
Bouhouita-Guermech, S., & Haidar, H. (2024) · Asian Bioethics Review · doi:10.1007/s41649-024-00292-7 · Cited by 10 · see citing works
Ali, I. E., Sumita, Y. I., & Wakabayashi, N. (2024) · Journal of Prosthodontics · doi:10.1111/jopr.13853 · Cited by 9 · see citing works
IR-GPT: AI Foundation Models to Optimize Interventional Radiology
Brenner, J., Anibal, J., Hazen, L., Song, M. J., Huth, H. B., Xu, D., Xu, S., & Wood, B. J. (2025) · CardioVascular and Interventional Radiology · doi:10.1007/s00270-024-03945-0 · Cited by 9 · see citing works
The social anatomy of AI anxiety: gender, generations, and technological exposure
Uğur, N. G., & Dursun, F. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1641546 · Cited by 7 · see citing works
Artificial Intelligence in Healthcare
Aggarwal, N., Matheny, M. E., Shachar, C., Wang, S. X. Y., & Israni, S. T. (2022) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197579329.013.50 · Cited by 6 · see citing works
Hou, J., Strand-Amundsen, R. J., Tronstad, C., Høgetveit, J. O., Martinsen, Ø. G., & Tønnessen, T. I. (2021) · Sensors · doi:10.3390/s21196691 · Cited by 6 · see citing works
Merchant, S. A., Merchant, N., Varghese, S. L., & Shaikh, M. J. S. (2025) · World Journal of Radiology · doi:10.4329/wjr.v17.i11.114754 · Cited by 6 · see citing works
Progress in the application of machine learning in CT diagnosis of acute appendicitis
Li, J., Ye, J., Luo, Y., Xu, T., & Jia, Z. (2025) · Abdominal Radiology · doi:10.1007/s00261-025-04864-5 · Cited by 4 · see citing works
Brady, A. P. (2024) · European Radiology · doi:10.1007/s00330-023-10488-4 · Cited by 3 · see citing works
Baalla, A., & JELLOULI, T. (2026) · Discover Artificial Intelligence · doi:10.1007/s44163-026-01242-y · Cited by 2 · see citing works
Application of Medical Robotics in Healthcare Sector
Girisha, L., Rao, G. V. P., Nithya, M., Muthukumaran, R., Akhila, A., & Nidhya, M. S. (2024) · Advances in medical diagnosis, treatment, and care (AMDTC) book series · doi:10.4018/979-8-3693-2105-8.ch002 · Cited by 2 · see citing works
Future of Medical Decision Support Systems
Köse, U., Deperlioğlu, Ö., Alzubi, J. A. A., & Pătruţ, B. (2020) · Studies in computational intelligence · doi:10.1007/978-981-15-6325-6_10 · Cited by 2 · see citing works
Marway, P. S., Figueroa, C. A., Baker, T., Tjahjadi, N., Spahlinger, G., & Burris, N. S. (2025) · Radiology Cardiothoracic Imaging · doi:10.1148/ryct.240490 · Cited by 1 · see citing works
Jovanović, S., Vukičević, J. P., Kilibarda, B., Milosavljević, M., & Bjegovic-Mikanovic, V. M. (2026) · Frontiers in Radiology · doi:10.3389/fradi.2026.1714029 · Cited by 1 · see citing works
Patient-Centred Communication in Imaging
Munro, L. (2023) · Springer eBooks · doi:10.1007/978-3-031-30866-6_2 · Cited by 1 · see citing works
Artificial Intelligence in Nuclear Cardiology
Sciagrà, R., Valente, S., & Dominietto, M. D. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14186416 · Cited by 1 · see citing works
Mandarano, P. (2023) · doi:10.31234/osf.io/bq4sf · Cited by 1 · see citing works
Artificial Intelligence in the Era of Clinical Imaging
Kolostoumpis, G., Vasila-Vakhnina, O., & Vasilas, N. (2022) · Advances in medical education, research, and ethics (AMERE) book series · doi:10.4018/978-1-7998-8871-0.ch015
Comment: Radiologists' perspectives on AI and opportunistic CT screening (OS)
Qamar, M. T., & Yasmeen, J. (2024) · Clinical Imaging · doi:10.1016/j.clinimag.2024.110360
Societal, Legal, and Ethical Aspects of Trustworthy AI
Abadía, M. C., Goisauf, M., Hesso, I., Kayyali, R., Kogut-Czarkowska, M., Martínez, R. M., & Jiménez, P. N. (2025) · Springer eBooks · doi:10.1007/978-3-031-89963-8_1
Automated Brain Tumor Classification Using Deep Learning and MRI Image Processing
Elsayad, A. M., Al-Wizrah, M. I., Al-Dosari, A. A., Al-Besher, A. A., Al-Suwais, S. F., & Al-Shehri, Z. D. (2026) · International Conference on AI Innovations and Industry (ICAIII) · doi:10.1109/icaiii69475.2026.11521248
- Authors
- Mudgal, K. S., & Das, N.
- Affiliations
- King's College Hospital NHS Foundation Trust (GB)
- East Kent Hospitals Foundation Trust, Canterbury, UK
- Corresponding author
- Mudgal, Keshav Shree
- ORCID
- Mudgal, Keshav Shree
- Venue
- BJR|Open
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-11-01
- Volume
- 2
- Issue
- 1
- Pages
- 20190020
- ISSN
- 2513-9878 (ISSN-L)
- PMC
- PMC7605209
- OpenAlex
- W2991302197
- Cited by
- 52
- References
- 17
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 13 · 2023: 10 · 2022: 8 · 2021: 7 · 2020: 2
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BJR|Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Social Sciences › Safety Research › Ethics and Social Impacts of AI
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
- Keywords
- artificial intelligence in radiology, AI ethics, AI regulation, informed consent, data quality, demographic representativeness, liability for AI errors, root cause analysis, AI governance, AI autonomy
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