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Abstract
Advances in artificial intelligence have cultivated a strong interest in developing and validating the clinical utilities of computer-aided diagnostic models. Machine learning for diagnostic neuroimaging has often been applied to detect psychological and neurological disorders, typically on small-scale datasets or data collected in a research setting. With the collection and collation of an ever-growing number of public datasets that researchers can freely access, much work has been done in adapting machine learning models to classify these neuroimages by diseases such as Alzheimer’s, ADHD, autism, bipolar disorder, and so on. These studies often come with the promise of being implemented clinically, but despite intense interest in this topic in the laboratory, limited progress has been made in clinical implementation. In this review, we analyze challenges specific to the clinical implementation of diagnostic AI models for neuroimaging data, looking at the differences between laboratory and clinical settings, the inherent limitations of diagnostic AI, and the different incentives and skill sets between research institutions, technology companies, and hospitals. These complexities need to be recognized in the translation of diagnostic AI for neuroimaging from the laboratory to the clinic.
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1 Massachusetts General Hospital, Center for Systems Biology, Boston, USA (GRID:grid.32224.35) (ISNI:0000 0004 0386 9924); Massachusetts Alzheimer’s Disease Research Center, Charlestown, USA (GRID:grid.419475.a) (ISNI:0000 0000 9372 4913)
2 Erasmus MC, Department of Radiology and Nuclear Medicine, Rotterdam, The Netherlands (GRID:grid.5645.2) (ISNI:000000040459992X)
3 University of Antwerp, Computational Neurology, Experimental Neurobiology Unit (ENU), Department of Biomedical Sciences, Antwerp, Belgium (GRID:grid.5284.b) (ISNI:0000 0001 0790 3681); Hasselt University, Biomedical Research Institute, Diepenbeek, Belgium (GRID:grid.12155.32) (ISNI:0000 0001 0604 5662)
4 Boston Children’s Hospital, Boston, USA (GRID:grid.2515.3) (ISNI:0000 0004 0378 8438)
5 University College London, Center for Medical Image Computing, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201); Harvard Medical School, Martinos Center for Biomedical Imaging, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Massachusetts Institute of Technology, Computer Science and Artificial Intelligence Laboratory, Cambridge, MA, USA (GRID:grid.116068.8) (ISNI:0000 0001 2341 2786)
6 Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
7 Massachusetts General Hospital, Center for Systems Biology, Boston, USA (GRID:grid.32224.35) (ISNI:0000 0004 0386 9924); Massachusetts Alzheimer’s Disease Research Center, Charlestown, USA (GRID:grid.419475.a) (ISNI:0000 0000 9372 4913); Massachusetts General Hospital, Department of Radiology, Boston, USA (GRID:grid.32224.35) (ISNI:0000 0004 0386 9924)