Patient perspectives on the use of artificial intelligence in prostate cancer diagnosis on MRI.

Objectives: This study investigated patients' acceptance of artificial intelligence (AI) for diagnosing prostate cancer (PCa) on MRI scans and the factors influencing their trust in AI diagnoses.

Materials and methods: A prospective, multicenter study was conducted between January and November 2023. Patients undergoing prostate MRI were surveyed about their opinions on hypothetical AI assessment of their MRI scans. The questionnaire included nine items: four on hypothetical scenarios of combinations between AI and the radiologist, two on trust in the diagnosis, and three on accountability for misdiagnosis. Relationships between the items and independent variables were assessed using multivariate analysis.

Results: A total of 212 PCa suspicious patients undergoing prostate MRI were included. The majority preferred AI involvement in their PCa diagnosis alongside a radiologist, with 91% agreeing with AI as the primary reader and 79% as the secondary reader. If AI has a high certainty diagnosis, 15% of the respondents would accept it as the sole decision-maker. Autonomous AI outperforming radiologists would be accepted by 52%. Higher educated persons tended to accept AI when it would outperform radiologists (p < 0.05). The respondents indicated that the hospital (76%), radiologist (70%), and program developer (55%) should be held accountable for misdiagnosis.

Conclusions: Patients favor AI involvement alongside radiologists in PCa diagnosis. Trust in AI diagnosis depends on the patient's education level and the AI performance, with autonomous AI acceptance by a small majority on the condition that AI outperforms a radiologist. Respondents held the hospital, radiologist, and program developers accountable for misdiagnosis in descending order of accountability.

Clinical relevance statement: Patients show a high level of acceptance for AI-assisted prostate cancer diagnosis on MRI, either alongside radiologists or fully autonomous, particularly if it demonstrates superior performance to radiologists alone.

Key points: Prostate cancer suspicious patients may accept autonomous AI based on performance. Patients prefer AI involvement alongside a radiologist in diagnosing prostate cancer. Patients indicate accountability for AI should be shared among multiple stakeholders.