Patient Preferences for Artificial Intelligence in Medical Imaging: A Single-Center Cross-Sectional Survey

Artificial Intelligence (AI) is rapidly being implemented into clinical practice to improve diagnostic accuracy and reduce provider burnout. However, patient self-perceived knowledge and perceptions of AI's role in their care remain unclear. This study aims to explore patient preferences regarding the use of and communication of AI in their care for patients undergoing cross-sectional imaging exams. This single-center cross-sectional study, a structured questionnaire recruited patients undergoing outpatient CT or MRI examinations between June and July 2024 to assess baseline self-perceived knowledge of AI, perspectives on AI in clinical care, preferences regarding AI-generated results, and economic considerations related to AI, using Likert scales and categorical questions. A total of 226 participants (143 females; mean age 53 years) were surveyed with 67.4% (151/224) reporting having minimal to no knowledge of AI in medicine, with lower knowledge levels associated with lower socioeconomic status (p < .001). 90.3% (204/226) believed they should be informed about the use of AI in their care, and 91.1% (204/224) supported the right to opt out. Additionally, 91.1% (204/224) of participants expressed a strong preference for being informed when AI was involved in interpreting their medical images. 65.6% (143/218) indicated that they would not accept a screening imaging exam exclusively interpreted by an AI algorithm. Finally, 91.1% (204/224) of participants wanted disclosure when AI was used and 89.1% (196/220) felt such disclosure and clarification of discrepancies should be considered standard care. To align AI adoption with patient preferences and expectations, radiology practices must prioritize disclosure, patient engagement, and standardized documentation of AI use without being overly burdensome to the diagnostic workflow. Patients prefer transparency for AI utilization in their care, and our study highlights the discrepancy between patient preferences and current clinical practice. Patients are not expected to determine the technical aspects of an image examination such as acquisition parameters or reconstruction kernel and must trust their providers to act in their best interest. Clear communication of how AI is being used in their care should be provided in ways that do not overly burden the radiologist.