Evidence map›Paper›PMID 38953330›Full record

ReviewDiagnostic and interventional radiology (Ankara, Turkey)2025

Bias in artificial intelligence for medical imaging: fundamentals, detection, avoidance, mitigation, challenges, ethics, and prospects.

Burak Koçak, Andrea Ponsiglione, Arnaldo Stanzione, Christian Bluethgen, João Santinha, Lorenzo Ugga, Merel Huisman, Michail E Klontzas, Roberto Cannella, Renato Cuocolo

Abstract readReview
In one paragraph

Review in Diagnostic and interventional radiology (Ankara, Turkey), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  12. Photo-Based Color Analysis in Restorative Dentistry: The Role of Artificial Intelligence Algorithms.Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] · 2026
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Burak KoçakUniversity of Health Sciences, Başakşehir Çam and Sakura City Hospital, Clinic of Radiology, İstanbul, Türkiye.ORCID 0000-0002-7307-396X
Andrea PonsiglioneUniversity of Naples Federico II, Department of Advanced Biomedical Sciences, Naples, Italy.ORCID 0000-0002-0105-935X
Arnaldo StanzioneUniversity of Naples Federico II, Department of Advanced Biomedical Sciences, Naples, Italy.ORCID 0000-0002-7905-5789
Christian BluethgenUniversity of Zurich, University Hospital Zurich, Diagnostic and Interventional Radiology, Zurich, Switzerland.ORCID 0000-0001-7321-5676
João SantinhaDigital Surgery LAB, Champalimaud Research, Champalimaud Foundation; Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.ORCID 0000-0001-8174-2943
Lorenzo UggaUniversity of Naples Federico II, Department of Advanced Biomedical Sciences, Naples, Italy.ORCID 0000-0001-7811-4612
Merel HuismanRadboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen, Netherlands.ORCID 0000-0003-2289-7130
Michail E KlontzasUniversity of Crete, School of Medicine, Department of Radiology; University Hospital of Heraklion, Department of Medical Imaging,Crete, Greece; Karolinska Institute, Department of Clinical Science Intervention and Technology (CLINTEC), Division of Radiology, Solna, Sweden.ORCID 0000-0003-2731-933X
Roberto CannellaUniversity of Palermo, Department of Biomedicine, Neuroscience and Advanced Diagnostics, Section of Radiology, Palermo, Italy.ORCID 0000-0002-3808-0785
Renato CuocoloUniversity of Salerno, Department of Medicine, Surgery and Dentistry, Baronissi, Italy.ORCID 0000-0002-1452-1574

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although artificial intelligence (AI) methods hold promise for medical imaging-based prediction tasks, their integration into medical practice may present a double-edged sword due to bias (i.e., systematic errors). AI algorithms have the potential to mitigate cognitive biases in human interpretation, but extensive research has highlighted the tendency of AI systems to internalize biases within their model. This fact, whether intentional or not, may ultimately lead to unintentional consequences in the clinical setting, potentially compromising patient outcomes. This concern is particularly important in medical imaging, where AI has been more progressively and widely embraced than any other medical field. A comprehensive understanding of bias at each stage of the AI pipeline is therefore essential to contribute to developing AI solutions that are not only less biased but also widely applicable. This international collaborative review effort aims to increase awareness within the medical imaging community about the importance of proactively identifying and addressing AI bias to prevent its negative consequences from being realized later. The authors began with the fundamentals of bias by explaining its different definitions and delineating various potential sources. Strategies for detecting and identifying bias were then outlined, followed by a review of techniques for its avoidance and mitigation. Moreover, ethical dimensions, challenges encountered, and prospects were discussed.

Indexed as

Artificial IntelligenceDiagnostic ImagingAlgorithmsBiasHumansArtificial intelligencebiasfairnessmachine learningmedical imagingradiology

Identifiers

PMID38953330
PMCPMC11880872

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.