Radiologists may misidentify AI images - Summary - MDSpire
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Radiologists may misidentify AI images

  • By

  • Andrea Surnit

  • August 26, 2026

  • 4 min

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Objective:

To assess the ability of radiologists to correctly identify artificial intelligence-generated radiological images compared to real images.

Approach:
  • Survey Methodology: 182 radiologists reviewed 30 images (20 AI-generated and 10 real) across various imaging modalities and subspecialties.
  • Image Generation: AI images were produced using Stable Diffusion version 2.1 and the DreamBooth approach, trained on 20 to 30 example images per modality.
  • Assessment Criteria: Correct classification of images as real or AI-generated was the primary assessment, with additional evaluations based on modality, experience, and confidence.
Key Findings:
  • Median correct classification rate was 78% across respondents.
  • 75% of AI-generated images (2,640 assessments) and 83% of real images (1,820 assessments) were correctly identified.
  • Classification accuracy varied by imaging modality: CT (70%), MRI (77%), ultrasound (88%), and radiographs (91%).
  • Radiologists with relevant subspecialty expertise had higher accuracy (81%) compared to those without (77%).
  • Confidence in classification was correlated with correct identification, varying by imaging modality.
Interpretation:

Radiologists demonstrated variable accuracy in identifying AI-generated images, influenced by imaging modality and subspecialty expertise.

Limitations:
  • Images were presented online, limiting interaction compared to clinical practice.
  • Unequal numbers of AI-generated and real images across modalities may affect results.
  • Participants were aware that some images were AI-generated, potentially biasing their assessments.
  • AI models were trained primarily on normal anatomy, limiting generalizability to pathological images.
  • Potential selection bias due to participant experience and subspecialty.
Conclusion:

Radiologists may struggle to distinguish AI-generated images from real ones, with performance varying by modality and expertise.

Sources:

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