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Multicenter Study
. 2025 Feb;35(2):769-775.
doi: 10.1007/s00330-024-11012-y. Epub 2024 Aug 14.

Patient perspectives on the use of artificial intelligence in prostate cancer diagnosis on MRI

Stefan J Fransen  1 , T C Kwee  2 , D Rouw  3 , C Roest  2 , Q Y van Lohuizen  2 , F F J Simonis  4 , P J van Leeuwen  5 , S Heijmink  5 , Y P Ongena  6 , M Haan  6 , D Yakar  2   5
Affiliations
Multicenter Study

Patient perspectives on the use of artificial intelligence in prostate cancer diagnosis on MRI

Stefan J Fransen et al. Eur Radiol. 2025 Feb.

Abstract

Objectives: This study investigated patients' acceptance of artificial intelligence (AI) for diagnosing prostate cancer (PCa) on MRI scans and the factors influencing their trust in AI diagnoses.

Materials and methods: A prospective, multicenter study was conducted between January and November 2023. Patients undergoing prostate MRI were surveyed about their opinions on hypothetical AI assessment of their MRI scans. The questionnaire included nine items: four on hypothetical scenarios of combinations between AI and the radiologist, two on trust in the diagnosis, and three on accountability for misdiagnosis. Relationships between the items and independent variables were assessed using multivariate analysis.

Results: A total of 212 PCa suspicious patients undergoing prostate MRI were included. The majority preferred AI involvement in their PCa diagnosis alongside a radiologist, with 91% agreeing with AI as the primary reader and 79% as the secondary reader. If AI has a high certainty diagnosis, 15% of the respondents would accept it as the sole decision-maker. Autonomous AI outperforming radiologists would be accepted by 52%. Higher educated persons tended to accept AI when it would outperform radiologists (p < 0.05). The respondents indicated that the hospital (76%), radiologist (70%), and program developer (55%) should be held accountable for misdiagnosis.

Conclusions: Patients favor AI involvement alongside radiologists in PCa diagnosis. Trust in AI diagnosis depends on the patient's education level and the AI performance, with autonomous AI acceptance by a small majority on the condition that AI outperforms a radiologist. Respondents held the hospital, radiologist, and program developers accountable for misdiagnosis in descending order of accountability.

Clinical relevance statement: Patients show a high level of acceptance for AI-assisted prostate cancer diagnosis on MRI, either alongside radiologists or fully autonomous, particularly if it demonstrates superior performance to radiologists alone.

Key points: Prostate cancer suspicious patients may accept autonomous AI based on performance. Patients prefer AI involvement alongside a radiologist in diagnosing prostate cancer. Patients indicate accountability for AI should be shared among multiple stakeholders.

Keywords: Artificial intelligence; Magnetic resonance imaging; Patient preference; Prostate cancer; Questionnaire.

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Conflict of interest statement

Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is S.J.F. Conflict of interest: D.Y. is a member of the Scientific Editorial Board of European Radiology (section: Imaging Informatics and Artificial Intelligence). They have not participated in the selection or review processes for this article. The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: No complex statistical methods were necessary for this paper. Informed consent: Written informed consent was waived by the local Institutional Review Boards. Ethical approval: Institutional Review Board approval was obtained. Study subjects or cohorts overlap: None. Methodology: Prospective Experimental/observational Multicenter study

Figures

Fig. 1
Fig. 1
STARD diagram. Adult men who underwent prostate MRI scans between January and November 2023 at institute A, institute B, and institute C were eligible for this study. Patients with an incomplete questionnaire or multiple answers to a single question were excluded
Fig. 2
Fig. 2
Patients’ responses to questions about their views on AI assessment of their prostate MRI scan
See this image and copyright information in PMC

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References

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