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

Journal: Diagnostic and interventional radiology (Ankara, Turkey)
Published Date:

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.

Authors

  • Burak Kocak
    Department of Radiology, Istanbul Training and Research Hospital, Istanbul, Turkey. drburakkocak@gmail.com.
  • Andrea Ponsiglione
    Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy.
  • Arnaldo Stanzione
    Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
  • Christian Bluethgen
    Stanford Center for Artificial Intelligence in Medicine and Imaging (AIMI), Stanford University, Sheffield, USA.
  • João Santinha
    Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal.
  • Lorenzo Ugga
    Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
  • Merel Huisman
    Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. merel.huisman1@gmail.com.
  • Michail E Klontzas
    Department of Medical Imaging, Heraklion University Hospital, Crete, 70110, Greece; Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), N. Plastira 100, Vassilika Vouton 70013, Heraklion, Crete, Greece. Electronic address: miklontzas@ics.forth.gr.
  • Roberto Cannella
    Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata, Università di Palermo.
  • Renato Cuocolo
    Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.