Evidence map›Paper›PMID 39455061›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2025

Real-world federated learning in radiology: hurdles to overcome and benefits to gain.

Markus Ralf Bujotzek, Ünal Akünal, Stefan Denner, Peter Neher, Maximilian Zenk, Eric Frodl, Astha Jaiswal, Moon Kim, Nicolai R Krekiehn, Manuel Nickel and 10 more

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–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

9 citing papers in PubMed.

  1. Article
  2. GEN-Guard: correcting generalization failures for deployable federated surgical AI.International journal of computer assisted radiology and surgery · 2026
    Article
  3. Article
  4. Review
  5. Article
  6. Review
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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

20 authors.

Markus Ralf BujotzekDivision of Medical Image Computing, German Cancer Research Center Heidelberg, Heidelberg, 69120, Germany.ORCID 0009-0006-4550-428X
Ünal AkünalDivision of Medical Image Computing, German Cancer Research Center Heidelberg, Heidelberg, 69120, Germany.
Stefan DennerDivision of Medical Image Computing, German Cancer Research Center Heidelberg, Heidelberg, 69120, Germany.
Peter NeherDivision of Medical Image Computing, German Cancer Research Center Heidelberg, Heidelberg, 69120, Germany.
Maximilian ZenkDivision of Medical Image Computing, German Cancer Research Center Heidelberg, Heidelberg, 69120, Germany.
Eric FrodlInstitute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt (Main), 60590, Germany.
Astha JaiswalInstitute for Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, 50937, Germany.
Moon KimInstitute for AI in Medicine (IKIM), University Hospital Essen (AöR), Essen, 45131, Germany.
Nicolai R KrekiehnIntelligent Imaging Lab@Section Biomedical Imaging, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kel, 24118, Germany.
Manuel NickelInstitute for AI in Medicine, Technical University of Munich, Munich, 81675, Germany.
Richard RuppelDepartment of Radiology, Charité-Universitätsmedizin Berlin, Berlin, 10117, Germany.
Marcus BothDepartment of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Kiel, 24105, Germany.
Felix DöllingerDepartment of Radiology, Charité-Universitätsmedizin Berlin, Berlin, 10117, Germany.
Marcel OpitzInstitute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen (AÖR), Essen, 45131, Germany.
Thorsten PersigehlInstitute for Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, 50937, Germany.
Jens KleesiekInstitute for AI in Medicine (IKIM), University Hospital Essen (AöR), Essen, 45131, Germany.
Tobias PenzkoferDepartment of Radiology, Charité-Universitätsmedizin Berlin, Berlin, 10117, Germany.
Klaus Maier-HeinDivision of Medical Image Computing, German Cancer Research Center Heidelberg, Heidelberg, 69120, Germany.
Andreas BucherInstitute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt (Main), 60590, Germany.
Rickmer BrarenInstitute for Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, 81675, Germany.

Funding

NUM 2.0 01KX2121
6 · The paper itself

Abstract

objectiveFederated Learning (FL) enables collaborative model training while keeping data locally. Currently, most FL studies in radiology are conducted in simulated environments due to numerous hurdles impeding its translation into practice. The few existing real-world FL initiatives rarely communicate specific measures taken to overcome these hurdles. To bridge this significant knowledge gap, we propose a comprehensive guide for real-world FL in radiology. Minding efforts to implement real-world FL, there is a lack of comprehensive assessments comparing FL to less complex alternatives in challenging real-world settings, which we address through extensive benchmarking. MATERIALS AND

methodsWe developed our own FL infrastructure within the German Radiological Cooperative Network (RACOON) and demonstrated its functionality by training FL models on lung pathology segmentation tasks across six university hospitals. Insights gained while establishing our FL initiative and running the extensive benchmark experiments were compiled and categorized into the guide.

resultsThe proposed guide outlines essential steps, identified hurdles, and implemented solutions for establishing successful FL initiatives conducting real-world experiments. Our experimental results prove the practical relevance of our guide and show that FL outperforms less complex alternatives in all evaluation scenarios. DISCUSSION AND

conclusionOur findings justify the efforts required to translate FL into real-world applications by demonstrating advantageous performance over alternative approaches. Additionally, they emphasize the importance of strategic organization, robust management of distributed data and infrastructure in real-world settings. With the proposed guide, we are aiming to aid future FL researchers in circumventing pitfalls and accelerating translation of FL into radiological applications.

Indexed as

RadiologyBenchmarkingGermanyHumansartificial intelligencedistributed systemsfederated learninghealthcare infrastructureradiology

Identifiers

PMID39455061
PMCPMC11648732

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.