Equity, diversity, and inclusion: variations in clinical and academic radiology

Equity, diversity, and inclusion (EDI) are fundamental to achieving fairness and representation in radiological research and practice. This review aims to examine how structural inequities related to race, sex, gender, age, disability, and socioeconomic status shape imaging research, workforce composition, and clinical outcomes. Racial disparities persist through outdated diagnostic assumptions and unequal access to imaging, while the limited representation of minority clinicians in leadership continues to affect research priorities and inclusivity. Similarly, sex and gender inequities also remain, with women being underrepresented in academic and interventional radiology, and transgender and gender diverse individuals often excluded from research and clinical systems. These gaps highlight the importance of inclusive mentorship, equitable leadership opportunities and consistent use of inclusive terminology. Differences in age, disability, and socioeconomic status affect participation and outcomes in imaging research. Older adults, children and people with disabilities are often excluded from imaging datasets, reducing generalisability and limiting the safe application of new technologies such as artificial intelligence. Socioeconomic inequities affect access to timely imaging and distort normative datasets, leading to misinterpretation of results in deprived populations. Inclusive recruitment, adaptive imaging protocols, and explicit consideration of social context in research design are essential to address these disparities. To address this, radiology must prioritise inclusive recruitment, adapt imaging protocols for underrepresented groups, and integrate EDI principles into study design, dataset curation, and peer review. Embedding these practices will enhance scientific validity, ethical integrity, and patient-centred care, ensuring that imaging research truly reflects the diverse populations it serves. CRITICAL RELEVANCE STATEMENT: This review highlights how addressing equity, diversity, and inclusion in radiological research and practice is essential for improving the relevance, accuracy, and fairness of imaging data and emerging technologies across diverse patient populations. KEY POINTS: Persistent gaps in diversity affect fairness within radiological research and clinical practice. Inequities hinder equitable representation and limit the generalisability of radiological findings. Inclusive practices better serve the diverse populations we care for.