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AI and Legal Liability, AI Breast Cancer Misses, and Braidwood Ruling
June 30, 2025
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Together with
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“Radiologists aren’t anti-AI. We just want the conversation to be honest, grounded, and informed by actual clinical experience.”
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Matt Covington, MD, on recent news coverage of AI and radiology.
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The Imaging Wire will not be publishing on July 3 in observance of the Independence Day holiday. We’ll be back in your inboxes on July 7. Enjoy the long weekend!
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What impact will artificial intelligence have on the legal liability of the radiologists who use it? A new study in NEJM AI suggests that medical malpractice juries may pass harsher judgment on radiologists when they make mistakes that disagree with AI findings.
AI is viewed as a technology that can save radiologists time while also helping them make more accurate diagnoses.
- But there’s a dark side to AI as well – what happens when AI findings aren’t correct, or when radiologists disagree with AI only to discover it was right all along?
In the new study, a research team led by Michael Bernstein, PhD, of Brown University queried 1.3k U.S. adults on their attitudes toward radiologists’ legal liability in two clinical use cases for AI – identifying brain bleeds and detecting lung cancers.
- Participants were asked if they felt radiologists met their duty of care to patients across different scenarios, such as whether the AI and the radiologist agreed or disagreed on the original diagnosis.
Responses were compared to a “no AI” control scenario in which respondents assessed legal liability if radiologists hadn’t used AI at all, with researchers finding …
- If radiologists disagreed with AI, more respondents found radiologists liable …
- Brain bleeds: 73% found radiologist liable (vs. 50% with no AI)
- Lung cancer: 79% found radiologist liable (vs. 64% with no AI)
- If both radiologists and AI missed the diagnosis, there was no statistically significant difference …
- Brain bleeds: (50% vs. 56% with no AI, p=0.33)
- Lung cancer: (64% vs. 65% with no AI, p=0.77)
- Respondents were less likely to side with plaintiffs when given information about standard AI error rates …
- When AI agreed with the radiologist diagnosis:
- Brain bleeds: (73% plaintiff agreement fell to 49%)
- Lung cancer: (79% fell to 73%)
- When AI disagreed with the radiologist diagnosis:
- Brain bleeds: (50% plaintiff agreement fell to 34%)
- Lung cancer: (64% fell to 56%)
The Takeaway
The new study offers a fascinating look at AI’s future in radiology from a medico-legal perspective. But there’s one question the researchers didn’t address: If AI-supported image interpretation eventually becomes the standard of care, will radiologists be found liable for not using it at all? Stay tuned.
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Radiology Advocacy, Challenges, and Innovation
In this episode of The Radiology Report podcast, Medality CEO Daniel Arnold sits down with Reno Radiological Associates CEO Anthony Dispenziere to discuss the business behind independent radiology practice and what it takes to stay competitive in an increasingly complex healthcare landscape.
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Maximize New CCTA Reimbursement with Philips CT 5300
Coronary CTA is the preferred noninvasive exam for detecting and ruling out CAD. Updated guidelines and improved reimbursement reinforce its value for stable or atypical chest pain. The CT 5300 from Philips delivers fast, high-quality, low-dose cardiac imaging using AI and zero-click motion correction.
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- Why AI Misses Breast Cancers: Why does AI miss some diagnoses, like breast cancer? Researchers from South Korea examined this question in a new paper in Radiology, using AI to analyze 1.1k breast cancer cases. AI missed 14% of cancers, with its false-negative rate highest for cases such as younger women, tumors ≤2 cm, BI-RADS 4, and fewer lymph node metastases. By cancer molecular subtype, the HER2-enriched subtype had the lowest false-negative rate (9%), followed by triple-negative (15%) and luminal subtypes (17%).
- Supreme Court Upholds Free Screenings, USPSTF: The U.S. Supreme Court on Friday issued two key rulings affecting healthcare in a lawsuit filed by health and wellness firm Braidwood Management. First, the court denied Braidwood’s challenge to Affordable Care Act provisions requiring insurance companies to fully pay for preventive care services like cancer screenings that have been recommended by USPSTF. The court also upheld the constitutionality of the USPSTF, which Braidwood had also challenged. The rulings protect patient access to preventive care without requiring cost-sharing.
- Patient Fees Limit DBT Access: Eliminating patient out-of-pocket fees for DBT exams improved patient access to the breast screening technology. In a new study in JACR, UCLA researchers analyzed exams from 13.3k women before and after a $45 fee was eliminated for DBT studies. Use of DBT increased 7.8 percentage points (from 84% to 92%), with larger increases seen in historically underserved women like Asian, Black, and Hispanic patients. The study shows how out-of-pocket fees can limit access to advanced technology.
- High-Res DBT Screening Finds More Cancer: Screening women with a high-resolution DBT system detected more breast cancer than standard-resolution DBT. Researchers writing in Clinical Imaging used Hologic’s DBT system in high-res mode (pixel size of 70 vs. 100 microns) and compared it to standard DBT across 184k mammograms. High-res DBT produced a 10% improvement in cancer detection rate per 1k women (5.4 vs. 4.9 cancers) with only a slight increase in the recall rate (9.8% vs. 9.1%).
- Quibim Launches Prostate MRI QA Tool: Recent research shows that one in three prostate MRI scans are not diagnostic quality. Quibim is addressing the issue with the launch of AI-QUAL, a new feature for its QP-Prostate platform that automatically assesses prostate MR image quality based on PI-QUAL v2 guidelines. AI-QUAL assigns a standardized score from 1-3 and automatically detects artifacts like rectal gas distortion and metal interference. Quibim in March received FDA clearance for QP-Prostate CAD, the latest version of QP-Prostate.
- FDA Clears Siemens Helium-Free MRI: Siemens Healthineers entered the U.S. market for helium-free MRI with the FDA clearance of Magnetom Flow.Ace, a 1.5T scanner with a closed helium circuit and no quench pipe. The scanner is based on the company’s DryCool technology and needs only 0.7 liters of helium compared to 1k liters for conventional MRI systems. Helium-free MRI scanners have lower installation and operating costs, and Magnetom Flow.Ace has 30% lower annual energy consumption than Siemens’ previous-generation scanner.
- Prenuvo Research on Lifestyle Impact: Prenuvo is highlighting research from ISMRM 2025 on how lifestyle can impact the brain. In the first study, MRI scans of 1.1k adults showed that those who drank two or more alcoholic drinks per day had measurable signs of brain atrophy, as well as larger liver and kidney volume. In the second, a study of 6.5k people showed that those with histories of depression had smaller brain volumes, but the decline was smaller in those who exercised regularly.
- Expanding CT Lung Screening’s Reach: CT lung cancer screening is gaining momentum, but are screening criteria still too restrictive? Writing in JAMA Network Open, researchers found that in a population of 43.5k people in the southern U.S., changing the USPSTF’s 2021 20-pack-year criteria to a simple 20-year smoking history would capture more people (21% vs. 13%), including more women (55% vs. 48%) and Black people (35% vs. 22%). Lowering the smoking history requirement even further – to 10 years – should be investigated.
- ASRT Ramps Up RT Visibility Campaign: ASRT is moving into the second phase of its Be Seen campaign to raise the profile of radiologic technologists and radiation therapy professionals. First launched in 2024, ASRT reports the campaign generated over 50M impressions across various media platforms. In its second phase, Be Seen will highlight the profession’s 12 individual practice areas through 30-second commercials airing on TV and social media platforms. GE HealthCare is providing production support for the initiative.
- Microsoft Releases AI Reporting Dataset: Microsoft released a new dataset of chest X-ray cases to be used for AI radiology report generation. The company’s PadChest-GR dataset was described in a recent paper in NEJM AI and consists of 4.6k grounded chest X-ray studies, in which findings have been annotated to ground truth by radiologists. Microsoft Research worked with a group from Spain on PadChest-GR, which is also bilingual (English and Spanish) and shows the benefits of integrating large language models with manually annotated data.
- United Imaging’s SNMMI 2025 Highlights: United Imaging highlighted its uExcel molecular imaging platform at last week’s SNMMI 2025 meeting. uExcel enables critical components to be shared across systems, and both the company’s uMI Panorama and uMI Panvivo PET/CT scanners use the technology, which includes ultra-digital detectors, the uAI Vision 3D camera, and AI-powered reconstruction. Other United Imaging SNMMI highlights were the company’s molecular imaging AI technology, which includes uAI MI Solution for PET/CT interpretation and uOmnispace for AI-based organ and lesion segmentation.
- Brainomix Partners with 3DR Labs: Brainomix will provide its Brainomix 360 Stroke AI solution to 3DR Labs under a new partnership between the companies. 3DR Labs offers medical image post-processing services and recently launched a dedicated division focusing on stroke, pre-surgical planning, and managing brain and spine diseases. Brainomix software will be integrated with 3DR Labs’ offerings to provide a seamless solution to clinical stroke teams.
- Interventional Rads Settle Billing Case: Two Florida interventional radiologists have agreed to pay $810k to settle federal charges that they performed and billed Medicare for medically unnecessary percutaneous transluminal angioplasty procedures. U.S. investigators accused Oscar Sosa, MD, and Osmany DeAngelo, DO, and their practices of performing “hundreds of PTAs” without determining if they were medically necessary. The allegations were raised in a whistleblower lawsuit filed by Emilio Lopez, MD, who will get a share of the settlement.
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Imaging Data There When You Need It
Discover the benefits of having imaging data there when you need it with Intelerad’s InteleArchive cloud-based archiving for long-term storage and disaster recovery.
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Clarity, Speed, and Confidence for MRI Efficiency
Radiologists have used a variety of methods to improve efficiency, but many of these methods come with drawbacks. Find out in this article how SpinTech MRI takes on the challenge of MRI efficiency with its STAGE software.
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- Remote vs. Tableside Fluoroscopy: Choosing the right fluoroscopy system is critical – download this e-book from Siemens Healthineers to discover key safety and efficiency factors that will help you decide between remote and tableside options.
- Catch What You’ve Missed on Unboxing AI: Missed an episode of Unboxing AI, CARPL’s video series on AI in radiology? Check out all the past episodes on their YouTube channel.
- AI-Powered Early Breast Cancer Detection: DeepHealth parent RadNet is expanding its presence in mammography AI with its pending acquisition of iCAD. Find out how the transaction will accelerate AI-powered early detection and diagnosis of breast cancer on this page.
- How CHU Bordeaux Integrated AI into Their Echo Lab: Bordeaux University Hospital evaluated the real-world use of AI in echocardiography with Us2.ai. Results showed strong agreement between AI-generated and human measurements, particularly for ejection fraction and Doppler-based parameters, highlighting AI’s potential to streamline workflow and reduce variability.
- Seamless, Connected Healthcare: Clearpath is committed to facilitating seamless, continued healthcare by optimizing automation and workflows between patients and providers. Learn how the company’s solutions contribute to a healthcare environment where every step of the patient journey is connected and efficient.
- Get Your Head Around AI for Neuroradiology: Check out the latest blog from Blackford on how advances in deep learning algorithms for neurology imaging are improving outcomes and easing the burden on radiologists.
- Preparing for the Future of Enterprise Imaging: What do health IT and imaging leaders need to know about moving medical images to the cloud? Find out how to prepare for enterprise imaging’s future in this downloadable e-book from Optum.
- Advancing AI-Driven Data Migration: Enlitic has joined forces with GE HealthCare to power the data migration feature in GE’s newly announced Genesis cloud portfolio. Learn how Enlitic’s AI-driven data migration facilitates large-scale transfers of high-quality medical imaging data.
- 95% Cost Reduction by Closing Sharing Gaps: Valley View Hospital eliminated image sharing friction by automating access for patients and out-of-network providers. The result? A 95% reduction in operational costs and a global reach that keeps care moving, wherever patients are. Learn how PocketHealth helped Valley View streamline access and cut overhead.
- Leading the Way in AI Transparency: There’s a need to better inform radiologists about AI’s role when interpreting images and generating measurements. Visage Imaging’s Visage 7 can display text in the viewer indicating that AI was used as a diagnostic aid – find out how it works today.
- Experience the Power of Workflow Orchestration: Mach7’s UnityVue Workflow Orchestration Platform is a groundbreaking new solution that creates a unified view of patient imaging data, speeding patient care delivery, creating more efficient workflows, and reducing radiologist stress. Experience the power of UnityVue for yourself.
- Opportunistic Detection of CAC and Pulmonary Nodules: Achieve a newfound certainty of search for thoracic CT when using ClearRead CT from Riverain Technologies. It’s a natural addition for opportunistic CAC scoring and nodule detection, or as part of a CT lung cancer screening program.
- Elevating Generative Reporting to the Web: Learn about the next leap in patient-focused diagnostic imaging with KailoFlow, the web-based evolution of Kailo Medical’s generative structured reporting platform that combines progress, innovation, and accessibility.
- Enterprise Imaging in Action: Find out how Presbyterian Healthcare increased patient engagement and met regulatory requirements by image-enabling their patient portal in this downloadable white paper from Merge.
- Unprecedented Insights Made Possible with AI: With the largest normative dataset of whole-body imaging in the world, Prenuvo’s AI researchers partner with the best academic minds to understand – like never before – what “normal” aging means. Learn about their work today.
- Revolutionize the Reading Experience: With intelligent automation and AI‑powered workflow, PowerScribe One from Microsoft allows radiologists to generate and communicate high‑quality, consistent reports – and get more done in less time.
- Introducing Voice-Controlled Interventional X-Ray: United Imaging’s uAngio AVIVA is the industry’s first intelligent voice-controlled interventional X-ray system, enabling interventional staff to keep their focus where it belongs: on the patient. Discover AVIVA’s advantages on this page.
- Top Productivity Tools for Radiologists: Radiologists today face growing demands for speed, collaboration, and accuracy. Watch this on-demand webinar to learn from clinical and IT leaders from the University of Michigan Health – Sparrow and AGFA HealthCare as they share the top tools helping radiologists work smarter.
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