Kostas Marias

Karim Lekadir, Aasa Feragen, Abdul Joseph Fofanah et al. · eth-zurich

Despite major advances in artificial intelligence (AI) for medicine and healthcare, the deployment and adoption of AI technologies remain limited in real-world clinical practice. In recent years, concerns have been raised about the technical, clinical, ethical and legal risks associated with medical AI. To increase real world adoption, it is essential that medical AI tools are trusted and accepted by patients, clinicians, health organisations and authorities. This work describes the FUTURE-AI guideline as the first international consensus framework for guiding the development and deployment of trustworthy AI tools in healthcare. The FUTURE-AI consortium was founded in 2021 and currently comprises 118 inter-disciplinary experts from 51 countries representing all continents, including AI scientists, clinicians, ethicists, and social scientists. Over a two-year period, the consortium defined guiding principles and best practices for trustworthy AI through an iterative process comprising an in-depth literature review, a modified Delphi survey, and online consensus meetings. The FUTURE-AI framework was established based on 6 guiding principles for trustworthy AI in healthcare, i.e. Fairness, Universality, Traceability, Usability, Robustness and Explainability. Through consensus, a set of 28 best practices were defined, addressing technical, clinical, legal and socio-ethical dimensions. The recommendations cover the entire lifecycle of medical AI, from design, development and validation to regulation, deployment, and monitoring. FUTURE-AI is a risk-informed, assumption-free guideline which provides a structured approach for constructing medical AI tools that will be trusted, deployed and adopted in real-world practice. Researchers are encouraged to take the recommendations into account in proof-of-concept stages to facilitate future translation towards clinical practice of medical AI.

Vasileios C. Pezoulas, Nikolaos S. Tachos, Eleni Georga et al.

In the rapidly evolving era of Artificial Intelligence (AI), synthetic data are widely used to accelerate innovation while preserving privacy and enabling broader data accessibility. However, the evaluation of synthetic data remains fragmented across heterogeneous metrics, ad-hoc scripts, and incomplete reporting practices. To address this gap, we introduce Synthetic Data Blueprint (SDB), a modular Pythonic based library to quantitatively and visually assess the fidelity of synthetic tabular data. SDB supports: (i) automated feature-type detection, (ii) distributional and dependency-level fidelity metrics, (iii) graph- and embedding-based structure preservation scores, and (iv) a rich suite of data visualization schemas. To demonstrate the breadth, robustness, and domain-agnostic applicability of the SDB, we evaluated the framework across three real-world use cases that differ substantially in scale, feature composition, statistical complexity, and downstream analytical requirements. These include: (i) healthcare diagnostics, (ii) socioeconomic and financial modelling, and (iii) cybersecurity and network traffic analysis. These use cases reveal how SDB can address diverse data fidelity assessment challenges, varying from mixed-type clinical variables to high-cardinality categorical attributes and high-dimensional telemetry signals, while at the same time offering a consistent, transparent, and reproducible benchmarking across heterogeneous domains.

Lidia Garrucho, Kaisar Kushibar, Claire-Anne Reidel et al.

Artificial Intelligence (AI) research in breast cancer Magnetic Resonance Imaging (MRI) faces challenges due to limited expert-labeled segmentations. To address this, we present a multicenter dataset of 1506 pre-treatment T1-weighted dynamic contrast-enhanced MRI cases, including expert annotations of primary tumors and non-mass-enhanced regions. The dataset integrates imaging data from four collections in The Cancer Imaging Archive (TCIA), where only 163 cases with expert segmentations were initially available. To facilitate the annotation process, a deep learning model was trained to produce preliminary segmentations for the remaining cases. These were subsequently corrected and verified by 16 breast cancer experts (averaging 9 years of experience), creating a fully annotated dataset. Additionally, the dataset includes 49 harmonized clinical and demographic variables, as well as pre-trained weights for a baseline nnU-Net model trained on the annotated data. This resource addresses a critical gap in publicly available breast cancer datasets, enabling the development, validation, and benchmarking of advanced deep learning models, thus driving progress in breast cancer diagnostics, treatment response prediction, and personalized care.

Karim Lekadir, Richard Osuala, Catherine Gallin et al.

The recent advancements in artificial intelligence (AI) combined with the extensive amount of data generated by today's clinical systems, has led to the development of imaging AI solutions across the whole value chain of medical imaging, including image reconstruction, medical image segmentation, image-based diagnosis and treatment planning. Notwithstanding the successes and future potential of AI in medical imaging, many stakeholders are concerned of the potential risks and ethical implications of imaging AI solutions, which are perceived as complex, opaque, and difficult to comprehend, utilise, and trust in critical clinical applications. Addressing these concerns and risks, the FUTURE-AI framework has been proposed, which, sourced from a global multi-domain expert consensus, comprises guiding principles for increased trust, safety, and adoption for AI in healthcare. In this paper, we transform the general FUTURE-AI healthcare principles to a concise and specific AI implementation guide tailored to the needs of the medical imaging community. To this end, we carefully assess each building block of the FUTURE-AI framework consisting of (i) Fairness, (ii) Universality, (iii) Traceability, (iv) Usability, (v) Robustness and (vi) Explainability, and respectively define concrete best practices based on accumulated AI implementation experiences from five large European projects on AI in Health Imaging. We accompany our concrete step-by-step medical imaging development guide with a practical AI solution maturity checklist, thus enabling AI development teams to design, evaluate, maintain, and deploy technically, clinically and ethically trustworthy imaging AI solutions into clinical practice.

Dimitrios G. Zaridis, Eugenia Mylona, Nikolaos S. Tachos et al.

Prostate segmentation from magnetic resonance imaging (MRI) is a challenging task. In recent years, several network architectures have been proposed to automate this process and alleviate the burden of manual annotation. Although the performance of these models has achieved promising results, there is still room for improvement before these models can be used safely and effectively in clinical practice. One of the major challenges in prostate MR image segmentation is the presence of class imbalance in the image labels where the background pixels dominate over the prostate. In the present work we propose a DL-based pipeline for cropping the region around the prostate from MRI images to produce a more balanced distribution of the foreground pixels (prostate) and the background pixels and improve segmentation accuracy. The effect of DL-cropping for improving the segmentation performance compared to standard center-cropping is assessed using five popular DL networks for prostate segmentation, namely U-net, U-net+, Res Unet++, Bridge U-net and Dense U-net. The proposed smart-cropping outperformed the standard center cropping in terms of segmentation accuracy for all the evaluated prostate segmentation networks. In terms of Dice score, the highest improvement was achieved for the U-net+ and ResU-net++ architectures corresponding to 8.9% and 8%, respectively.