Abstract
Objectives
Artificial intelligence (AI) has the potential to impact clinical practice and healthcare delivery. AI is of particular significance in radiology due to its use in automatic analysis of image characteristics. This scoping review examines stakeholder perspectives on AI use in radiology, the benefits, risks, and challenges to its integration.
Methods
A search was conducted from 1960 to November 2019 in EMBASE, PubMed/MEDLINE, Web of Science, Cochrane Library, CINAHL, and grey literature. Publications reflecting stakeholder attitudes toward AI were included with no restrictions.
Results
Commentaries (n = 32), surveys (n = 13), presentation abstracts (n = 8), narrative reviews (n = 8), and a social media study (n = 1) were included from 62 eligible publications. These represent the views of radiologists, surgeons, medical students, patients, computer scientists, and the general public. Seven themes were identified (predicted impact, potential replacement, trust in AI, knowledge of AI, education, economic considerations, and medicolegal implications). Stakeholders anticipate a significant impact on radiology, though replacement of radiologists is unlikely in the near future. Knowledge of AI is limited for non-computer scientists and further education is desired. Many expressed the need for collaboration between radiologists and AI specialists to successfully improve patient care.
Conclusions
Stakeholder views generally suggest that AI can improve the practice of radiology and consider the replacement of radiologists unlikely. Most stakeholders identified the need for education and training on AI, as well as collaborative efforts to improve AI implementation. Further research is needed to gain perspectives from non-Western countries, non-radiologist stakeholders, on economic considerations, and medicolegal implications.
Key Points
-
Stakeholders generally expressed that AI alone cannot be used to replace radiologists. The scope of practice is expected to shift with AI use affecting areas from image interpretation to patient care.
-
Patients and the general public do not know how to address potential errors made by AI systems while radiologists believe that they should be “in-the-loop” in terms of responsibility. Ethical accountability strategies must be developed across governance levels.
-
Students, residents, and radiologists believe that there is a lack in AI education during medical school and residency. The radiology community should work with IT specialists to ensure that AI technology benefits their work and centres patients.
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Abbreviations
- AI:
-
Artificial intelligence
- ANN:
-
Artificial neural networks
- CADTH:
-
Canadian Agency for Drugs and Technologies in Health
- CINAHL:
-
Cumulative Index to Nursing and Allied Health Literature
- DL:
-
Deep learning
- ML:
-
Machine learning
- PRISMA:
-
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
References
Klumpp M (2018) Automation and artificial intelligence in business logistics systems: human reactions and collaboration requirements. Int J Log Res Appl 21:224–242
Elizalde-Ramírez F, Nigenda RS, Martínez-Salazar IA, Ríos-Solís YÁ (2019) Travel plans in public transit networks using artificial intelligence planning models. Appl Artif Intell 33:440–461
Alarie B, Niblett A, Yoon AH (2018) How artificial intelligence will affect the practice of law. Univ Tor Law J 68:106–124
Nguyen H, Bui X-N (2019) Predicting blast-induced air overpressure: a robust artificial intelligence system based on artificial neural networks and random forest. Nat Resour Res 28:893–907
Rodríguez F, Fleetwood A, Galarza A, Fontán L (2018) Predicting solar energy generation through artificial neural networks using weather forecasts for microgrid control. Renew Energy 126:855–864
Krittanawong C (2018) The rise of artificial intelligence and the uncertain future for physicians. Eur J Intern Med 48:e13–e14
Ramesh A, Kambhampati C, Monson JR, Drew P (2004) Artificial intelligence in medicine. Ann R Coll Surg Engl 86:334
Ardila D, Kiraly AP, Bharadwaj S et al (2019) End-to-end lung cancer screening with three-dimensional deep learning on low-dose chest computed tomography. Nat Med 25:954
Lorenzetti L (2016) Here’s how IBM Watson Health is transforming the health care industry. Fortune (April 5)
Bloch-Budzier S (2016) NHS using Google technology to treat patients. BBC News 22
Conant EF, Toledano AY, Periaswamy S et al (2019) Improving accuracy and efficiency with concurrent use of artificial intelligence for digital breast tomosynthesis. Radiology: AI 1:e180096
Gottumukkala RV, Le TQ, Duszak R Jr, Prabhakar AM (2018) Radiologists are actually well positioned to innovate in patient experience. Curr Probl Diagn Radiol 47:206–208
Obermeyer Z, Emanuel EJ (2016) Predicting the future—big data, machine learning, and clinical medicine. N Engl J Med 375:1216
Kruskal JB, Berkowitz S, Geis JR, Kim W, Nagy P, Dreyer K (2017) Big data and machine learning—strategies for driving this bus: a summary of the 2016 intersociety summer conference. J Am Coll Radiol 14:811–817
Tang A, Tam R, Cadrin-Chênevert A et al (2018) Canadian Association of Radiologists white paper on artificial intelligence in radiology. Can Assoc Radiol J 69:120–135
Pesapane F, Codari M, Sardanelli F (2018) Artificial intelligence in medical imaging: threat or opportunity? Radiologists again at the forefront of innovation in medicine. Eur Radiol Exp 2:35
Faggella D (2020) What is Machine Learning. Available via https://emerj.com/ai-glossary-terms/what-is-machine-learning/
Wiemken TL, Kelley RR (2020) Machine learning in epidemiology and health outcomes research. Annu Rev Public Health 41:21–36
Alpaydin E (2014) Introduction to machine learning, 3 edn
Lisboa PJ, Taktak AF (2006) The use of artificial neural networks in decision support in cancer: a systematic review. Neural Netw 19:408–415
Sherriff A, Ott J, Team AS (2004) Artificial neural networks as statistical tools in epidemiological studies: analysis of risk factors for early infant wheeze. Paediatr Perinat Epidemiol 18:456–463
LeCun Y, Bengio Y, Hinton G (2015) Deep learning. Nature 521:436–444
Ching T, Himmelstein DS, Beaulieu-Jones BK et al (2018) Opportunities and obstacles for deep learning in biology and medicine. J R Soc Interface 15
Suzuki K (2017) Overview of deep learning in medical imaging. Radiol Phys Technol 10:257–273
Levac D, Colquhoun H, O’Brien KK (2010) Scoping studies: advancing the methodology. Implement Sci 5:69
Arksey H, O’Malley L (2005) Scoping studies: towards a methodological framework. Int J Soc Res Methodol 8:19–32
Canadian Agency for Drugs and Technologies in Health (2013) Grey Matters: a practical search tool for evidence-based medicine. CADTH, Ottawa. Available via https://www.cadth.ca/resources/finding-evidence/grey-matters
Tricco AC, Lillie E, Zarin W et al (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169:467–473
Ooi SKG, Makmur A, Soon AYQ et al (2019) Attitudes toward artificial intelligence in radiology with learner needs assessment within radiology residency programmes: a national multi-programme survey. Singap Med J:04
Eltorai AEM, Bratt AK, Guo HH (2019) Thoracic radiologists’ versus computer scientists’ perspectives on the future of artificial intelligence in radiology. J Thorac Imaging 35:255–259
Gong B, Nugent JP, Guest W et al (2019) Influence of artificial intelligence on Canadian medical students’ preference for radiology specialty: a national survey study. Acad Radiol 26:566–577
European Society of Radiology (ESR) (2019) Impact of artificial intelligence on radiology: a EuroAIM survey among members of the European Society of Radiology. Insights Imaging 10:105
Aminololama-Shakeri S, Lopez JE (2019) The doctor-patient relationship with artificial intelligence. AJR Am J Roentgenol 212:308–310
Shalaby SM, El-Badawy M, Hanafy A (2019) A white paper on artificial intelligence in radiology, getting over the hype. Clin Radiol 74 (Supplement 2):e11
Aerts HJWL (2018) Data science in radiology: a path forward. Clin Cancer Res 24:532–534
Beregi JP, Zins M, Masson JP et al (2018) Radiology and artificial intelligence: an opportunity for our specialty. Diagn Interv Imaging 99:677–678
Hirschmann A, Cyriac J, Stieltjes B, Kober T, Richiardi J, Omoumi P (2019) Artificial intelligence in musculoskeletal imaging: review of current literature, challenges, and trends. Semin Musculoskelet Radiol 23:304–311
Moore MM, Slonimsky E, Long AD, Sze RW, Iyer RS (2019) Machine learning concepts, concerns and opportunities for a pediatric radiologist. Pediatr Radiol 49:509–516
Nguyen GK, Shetty AS (2018) Artificial intelligence and machine learning: opportunities for radiologists in training. J Am Coll Radiol 15:1320–1321
Chan S, Siegel EL (2019) Will machine learning end the viability of radiology as a thriving medical specialty? Br J Radiol 92(1094). https://doi.org/10.1259/bjr.20180416
Yi PH, Hui FK, Ting DSW (2018) Artificial intelligence and radiology: collaboration is key. J Am Coll Radiol 15:781–783
Syed AB, Zoga AC (2018) Artificial intelligence in radiology: current technology and future directions. Semin Musculoskelet Radiol 22:540–545
Giger ML (2018) Machine learning in medical imaging. J Am Coll Radiol Part B 15:512–520
Nawrocki T, Maldjian PD, Slasky SE, Contractor SG (2018) Artificial intelligence and radiology: have rumors of the radiologist’s demise been greatly exaggerated? Acad Radiol 25:967–972
Dreyer KJ, Geis JR (2017) When machines think: radiology’s next frontier. Radiology 285:713–718
Kohli M, Prevedello LM, Filice RW, Geis JR (2017) Implementing machine learning in radiology practice and research. AJR Am J Roentgenol 208:754–760
Chockley K, Emanuel E (2016) The end of radiology? Three threats to the future practice of radiology. J Am Coll Radiol Part PA 13:1415–1420
European Society of Radiology (ESR) (2019) What the radiologist should know about artificial intelligence - an ESR white paper. Insights Imaging 10:44
Langs G, Rohrich S, Hofmanninger J et al (2018) Machine learning: from radiomics to discovery and routine. Radiologe 58:1–6
Wong SH, Al-Hasani H, Alam Z, Alam A (2019) Artificial intelligence in radiology: how will we be affected? Eur Radiol 29:141–143
Brotchie P (2019) Machine learning in radiology. J Med Imaging Radiat Oncol 63:25–26
Kocak B, Durmaz ES, Ates E, Kilickesmez O (2019) Radiomics with artificial intelligence: a practical guide for beginners. Diagn Interv Radiol 25:485–495
Marieke H, Yfke PO, Saar H, Thomas CK, Derya Y (2019) A qualitative study to understand patient perspective on the use of artificial intelligence in radiology. J Am Coll Radiol 16:1416–1419
Goldberg JE, Rosenkrantz AB (2019) Artificial intelligence and radiology: a social media perspective. Curr Probl Diagn Radiol 48:308–311
Jalal S, Nicolaou S, Parker W (2019) Artificial intelligence, radiology, and the way forward. Can Assoc Radiol J 70:10–12
Hainc N, Federau C, Stieltjes B, Blatow M, Bink A, Stippich C (2017) The bright, artificial intelligence-augmented future of neuroimaging reading. Front Neurol 8 (SEP). https://doi.org/10.3389/fneur.2017.00489
Blum A, Zins M (2017) Radiology: is its future bright? Diagn Interv Imaging 98:369–371
Haan M, Ongena YP, Hommes S, Kwee TC, Yakar D (2019) A qualitative study to understand patient perspective on the use of artificial intelligence in radiology. J Am Coll Radiol 16:1416–1419
Collado-Mesa F, Alvarez E, Arheart K (2018) The role of artificial intelligence in diagnostic radiology: a survey at a single radiology residency training program. J Am Coll Radiol 15:1753–1757
Waymel Q, Badr S, Demondion X, Cotten A, Jacques T (2019) Impact of the rise of artificial intelligence in radiology: what do radiologists think? Diagn Interv Imaging 100:327–336
Koh DM (2019) Attitudes and perception of artificial intelligence and machine learning in oncological imaging. Cancer Imaging Conference: 19th Meeting and Annual of the International Cancer Imaging Society Italy 19. https://doi.org/10.3389/frai.2020.578983
Jv H, Huber A, Leichtle A et al (2019) A survey on the future of radiology among radiologists, medical students and surgeons: students and surgeons tend to be more skeptical about artificial intelligence and radiologists may fear that other disciplines take over. Eur J Radiol 121. https://doi.org/10.1016/j.ejrad.2019.108742
Tajmir SH, Alkasab TK (2018) Toward augmented radiologists: changes in radiology education in the era of machine learning and artificial intelligence. Acad Radiol 25:747–750
Liew C (2018) The future of radiology augmented with Artificial Intelligence: a strategy for success. Eur J Radiol 102:152–156
Mazurowski MA (2019) Artificial intelligence may cause a significant disruption to the radiology workforce. J Am Coll Radiol 16:1077–1082
Gallix B, Chong J (2019) Artificial intelligence in radiology: who’s afraid of the big bad wolf? Eur Radiol 29:1637–1639
Massat MB (2018) A promising future for AI in breast cancer screening. Appl Radiol 47:22–25
Kim W (2019) Imaging informatics. Fear, hype, hope, and reality: how AI is entering the health care system. Radiology Today 20:6–7
Thrall JH, Li X, Li Q et al (2018) Artificial intelligence and machine learning in radiology: opportunities, challenges, pitfalls, and criteria for success. J Am Coll Radiol 15:504–508
Recht M, Bryan RN (2017) Artificial intelligence: threat or boon to radiologists? J Am Coll Radiol 14:1476–1480
Conway S (2017) The Radiologisaurus: why THEY want YOU to become a dinosaur. Appl Radiol 46:30
Santos DP, Giese D, Brodehl S et al (2019) Medical students’ attitude towards artificial intelligence: a multicentre survey. Eur Radiol 29:1640–1646
Dbouk S, Auloge P, Cazzato RL et al (2019) Awareness and knowledge of interventional radiology by medical students in one of the largest medical schools in France. Cardiovasc Interv Radiol 42(3 Supplement):S284
Ongena YP, Haan M, Yakar D, Kwee TC (2019) Patients’ views on the implementation of artificial intelligence in radiology: development and validation of a standardized questionnaire. Eur Radiol. https://doi.org/10.1007/s00330-019-06486-0
Yamada K (2018) The future of radiology? Asian perspectives. Neuroradiology 60 (1 Supplement 1):93-94
Rosenkrantz AB, Hawkins CM (2017) Use of Twitter polls to determine public opinion regarding content presented at a major national specialty society meeting. J Am Coll Radiol 14:177–182
Wolff J, Pauling J, Keck A, Baumbach J (2020) The economic impact of artificial intelligence in health care: systematic review. J Med Internet Res 22(2):e16866
Hosny A, Parmar C, Quackenbush J, Schwartz LH, Aerts HJ (2018) Artificial intelligence in radiology. Nat Rev Cancer 18:500
Saba L, Biswas M, Kuppili V et al (2019) The present and future of deep learning in radiology. Eur J Radiol 114:14–24
Geis JR, Brady AP, Wu CC et al (2019) Ethics of artificial intelligence in radiology: summary of the joint European and North American multisociety statement. Can Assoc Radiol J 70:329–334
Kobayashi Y, Ishibashi M, Kobayashi H (2019) How will “democratization of artificial intelligence” change the future of radiologists? Jpn J Radiol 37:9–14
Reiner BI (2014) A crisis in confidence: a combined challenge and opportunity for medical imaging providers. J Am Coll Radiol 11:107–108
Strickland N (2018) What can Radiologists realistically expect from artificial intelligence? J Med Imaging Radiat Oncol 62:56–83
Pesapane F (2019) How scientific mobility can help current and future radiology research: a radiology trainee’s perspective. Insights Imaging 10:85
Bratt A (2019) Why radiologists have nothing to fear from deep learning. J Am Coll Radiol 16:1190–1192
O’Regan D (2017) The power of “Big Data”: a digital revolution in clinical radiology? Cardiovasc Interv Radiol 39:778–781
Schier R (2018) Artificial intelligence and the practice of radiology: an alternative view. J Am Coll Radiol 15:1004–1007
Tang L (2018) Radiological evaluation of advanced gastric cancer: from image to big data radiomics. Chin J Gastrointest Surg 21:1106
Burdorf B (2019) A medical student’s outlook on radiology in light of artificial intelligence. J Am Coll Radiol 16:1514–1515
Purohit K (2019) Growing interest in radiology despite AI fears. Acad Radiol 26:e75
Odle T (2020) The AI era: the role of medical imaging and radiation therapy professionals. Radiol Technol 91:391–400
Woznitza N (2020) Artificial intelligence and the radiographer/radiological technologist profession: a joint statement of the International Society of Radiographers and Radiological Technologists and the European Federation of Radiographer Societies. Radiography 26:93–95
Funding
The authors state that this work has not received any funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Guarantor
The scientific guarantor of this publication is Pasqualina (Lina) Santaguida.
Conflict of Interest
The authors declare no competing interests.
Statistics and Biometry
No complex statistical methods were necessary for this paper.
Informed Consent
Written informed consent was not required for this study because this study is based on a review of publicly available data and does not involve human or animal subjects.
Ethical Approval
Institutional Review Board approval was not required because this study is based on a review of publicly available data and does not involve human or animal subjects.
Methodology
• scoping review
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Ling Yang and Ioana Cezara Ene are co-first authors.
Supplementary information
ESM 1
(DOCX 244 kb)
Rights and permissions
About this article
Cite this article
Yang, ., Ene, I.C., Arabi Belaghi, R. et al. Stakeholders’ perspectives on the future of artificial intelligence in radiology: a scoping review. Eur Radiol 32, 1477–1495 (2022). https://doi.org/10.1007/s00330-021-08214-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-021-08214-z