Designing Clinically Translatable Artificial Intelligence Systems for High-Dimensional Medical Imaging

The National Institutes of Health in 2018 identified key focus areas for the future of artificial intelligence in medical imaging, creating a foundational roadmap for research in image acquisition, algorithms, data standardization and translatable clinical decision support systems. Among the key issues raised in the report, data availability, the need for novel computing architectures and explainable artificial intelligence algorithms are still relevant, despite the tremendous progress made over the past few years alone. Furthermore, translational goals of data sharing, validation of performance for regulatory approval, generalizability and mitigation of unintended bias must be accounted for early in the development process. In this Perspective, we explore challenges unique to high-dimensional clinical imaging data, in addition to highlighting some of the technical and ethical considerations involved in developing machine learning systems that better represent the high-dimensional nature of many imaging modalities. Furthermore, we argue that methods that attempt to address explainability, uncertainty and bias should be treated as core components of any clinical machine learning system.