Real‑world validation still matters for imaging AI | Martin Willemink
Over the past few years, intracranial hemorrhage (ICH) detection has become one of the most mature and regulated use cases in clinical imaging AI. Multiple FDA‑cleared models are now clinically used in radiology workflows. However, recent evidence suggests that deployment maturity does not necessarily mean that models are clinically robust. Since ICH detection has been on the market for a while now, multiple studies on post-deployment evaluation are coming out. Two recent papers examining commercial ICH detection models illustrate both progress and persistent gaps. Together, they emphasize an important lesson for imaging AI research: performance claims are dependent on the data distributions on which models are trained and evaluated. Training an AI model on population A does not mean it will perform well in population B. Understanding where and why models fail is the foundation for the next generation of clinically meaningful AI. Real‑world performance of a commercial ICH model C...