Special Articles • Opinion

West et al.
Global Trend in AI-Based Publications in Radiology

Special Articles
Opinion

Global Trend in Artificial

Intelligence–Based Publications in
Radiology From 2000 to 2018
Elizabeth West 1 OBJECTIVE. The purpose of this study is to evaluate the global trend in artificial intel-
Simukayi Mutasa1 ligence (AI)-based research productivity involving radiology and its subspecialty disciplines.
Zelos Zhu2 CONCLUSION. The United States is the global leader in AI radiology publication pro-
Richard Ha3 ductivity, accounting for almost half of total radiology AI output. Other countries have in-
creased their productivity. Notably, China has increased its productivity exponentially to
West E, Mutasa S, Zhu Z, Ha R close to 20% of all AI publications. The top three most productive radiology subspecialties
were neuroradiology, body and chest, and nuclear medicine.

n recent years, there has been an “Bayesian networks,” “cluster analysis,”

I explosion in the growth of artifi- “feature learning,” “feature extraction,” and

American Journal of Roentgenology

cial intelligence (AI) research, “principal components analysis.”

Keywords: artificial intelligence, artificial neural
network, bibliometric
doi.org/10.2214/AJR.19.21346
Received February 21, 2019; accepted after revision
May 26, 2019.
1
Department of Radiology, Columbia University Medical
Center, New York Presbyterian Hospital, New York, NY.
2
Columbia Mailman School of Public Health, New York, NY.
3
Breast Imaging Section, Columbia University Medical
Center, New York Presbyterian Hospital, 622 W 168th St,
PB-1-301, New York, NY 10032. Address correspondence
to R. Ha (rh2616@columbia.edu).
AJR 2019; 213:1–3
0361–803X/19/2136–1
© American Roentgen Ray Society
particularly in the engineering,
biotechnology, and medical industries [1]. In
the field of medicine, radiology in particular
lends itself to AI research because of its large
digital data sets [2]. In response, the radiology
community has largely embraced AI research,
as has been shown by the growing number of
publications focusing on such research and the
attention it has been given at large radiology
society meetings [3]. Despite the burgeoning
nature of the field, little is known about the
global trend in radiology AI research. The
purpose of this study was to perform a large
database query to evaluate the global trend in
AI research productivity involving the field of
radiology and its subspecialties.
Materials and Methods
All publication searches were performed
using a comprehensive central database
(Web of Science Core Collection, Clarivate
Analytics) that searches the world’s leading
scholarly journals and proceedings in the
sciences and includes the MEDLINE and
PubMed databases.
From 2000 to 2018, all AI-related pub-
lications were selected using the follow-
ing search terms: “artificial intelligence,”
“AI,” “CNN,” “CNNs,” “ANN,” “ANNs,”
“neural network,” “neural networks,” “ma-
chine learning,” “deep learning,” “computer
learning,” “support vector machine,” “sup-
port vector machines,” “Bayesian network,”
Radiology-specific AI research was se-
lected using the predefined database cate-
gory “Radiology Nuclear Medicine Medical
Imaging.” The resulting publication database
was then categorized by country of origin,
funding agencies, organizations, publication
type, and journal.
Nine radiology subspecialty publica-
tions were evaluated using the following
search terms. The chest and body terms
were “chest,” “body,” “lungs,” “lung,” “kid-
ney,” “renal,” “liver,” “hepatic,” “gallblad-
der,” “biliary,” “pancreas,” “pancreatic,”
“peritoneum,” “peritoneal,” “gyn,” “gy-
necologic,” “uterus,” “uterine,” “ovary,”
“ovarian,” “prostate,” “prostatic,” “splen-
ic,” “spleen,” “intestine,” “intestinal,” “co-
lon,” “colonic,” “appendix,” “appendiceal,”
“stomach,” “gastric,” “testes,” “testicular,”
“rectum,” and “rectal.” The musculoskel-
etal terms were “bone,” “musculoskeletal,”
“osseous,” “joint,” “muscle,” “skeletal,” and
“spine.” The pediatrics terms were “pedi-
atric,” “child,” and “children.” The neuro-
radiology terms were “brain,” “neuro,” and
“CNS.” The breast term was “breast.” The
nuclear medicine terms were “PET,” “la-
beled,” “FDG,” “radionuclides,” “radiophar-
maceuticals,” and “technetium.” The cardiac
terms were “cardiac” and “heart.” The inter-
ventional terms were “intervention” and “in-
terventional.” The emergency terms were
“emergency,” “trauma,” and “traumatic.”

AJR:213, December 2019 1

 West et al.

The global trend in the number of AI pub- 2000

lications from 2000 to 2018, including con- United States
tributing countries, was determined by linear China
and nonlinear regression analyses performed
using a statistical software program; p ≤ 0.05 Germany
1500
was considered significant.
United Kingdom

No. of Publications
Results Canada
Our bibliometric analysis yielded 8813
Japan
radiology AI publications worldwide from 1000
2000 to 2018. The global growth trend in AI The Netherlands
research was exponential (p < 0.0001; Fig. 1).
France
The top 12 most productive countries were
the United States, China, Germany, the Unit- 500 India
ed Kingdom, Canada, Japan, The Nether-
lands, France, India, Italy, South Korea, and Italy
Australia (Table 1). The United States had South Korea
the highest AI publication output since 2000,
0
accounting for approximately 35–50% of the Australia
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
total output (Fig. 2). China was the second

20
20
20
20
20
20
20
20
20
20
20
20

20
20
20
20
20
20
20
most productive country in the world, con- Year
tributing 18% of the total output in 2018.
The four countries that served as the top Fig. 1—Graph of number of radiology artificial intelligence publications by country and per year (2000–2018).
funding sources for radiology AI publi-
cations from 2000 to 2018 were the Unit- The journals in which these were published Discussion
American Journal of Roentgenology

ed States (16.5%), China (3.6%), the United
Kingdom (1.5%), and Canada (0.6%). The top
funding sources in the United States includ-
ed the National Institutes of Health (NIH;
public source), the National Cancer Insti-
tute, and the National Science Foundation
(public source). In China, the top funding
sources included the National Natural Sci-
ence Foundation of China (public source)
and the National Science Foundation of Chi-
na (public source). In the United Kingdom,
the top funding sources included the Medi-
cal Research Council (public source) and the
Wellcome Trust (private nonprofit source). In
Canada, the top funding sources included the
Canadian Institute of Health Research (pub-
most frequently were NeuroImage (16.1%), There has been an exponential growth
IEEE Transactions on Medical Imaging worldwide in AI radiology research, led by
(6.9%), and Medical Physics (6.9%). the United States, which produces almost
The subspecialties with the most AI-relat- half of global AI research. This is not sur-
ed publications were neuroradiology (24.4%), prising given that the United States also has
chest and body (20.7%), nuclear medicine the most funding sources for AI research.
(13.0%), and breast imaging (12.0%) (Table 2). Most U.S. funding has come from large gov-
50
United States
China
Germany
United Kingdom
40
Canada
The Netherlands
France
Annual Publications

Japan
30
lic source). India
The top three organizations in research Italy
productivity were were from the United South Korea
Australia
States (the University of California system, 20
the NIH, and Harvard University). Other top
organizations from other countries includ-
ed the University of London (United King-
dom), Institut National de la Santé et de la 10
Recherche Médicale (France), the Chinese
Academy of Science (China), the Helmholtz
Association (Germany), Radboud Universi-
ty Nijmegen (The Netherlands), the Univer- 0
sity of Toronto (Canada), and Seoul National
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
20
20
20
20
20
20
20
20
20
20
20
20

20
20
20
20
20
20
20

University (South Korea). Year

The types of publications identified most
often were articles (53.7%), proceedings pa- Fig. 2—Line graph of percentage of total radiology artificial intelligence publications by country and per year
pers (38.0%), and meeting abstracts (6.8%). (2000–2018).

2 AJR:213, December 2019

 TABLE 1:  Countries With Highest Numbers of Radiology Artificial Intelligence dition, the proprietary “Radiology Nuclear
Global Trend in AI-Based Publications in Radiology
Publications (2000–2018) Medicine Medical Imaging” category like-
Rank Country Total No. of Publications
ly would have excluded relevant studies that
were presented at non–radiology-specific
1 United States 3836 meetings and published in non–radiology-
2 China 973 specific journals that did meet the preset
3 Germany 762 criteria. Two other factors added to the un-
derestimation of the total AI research pro-
4 United Kingdom 612
ductivity: Studies from the arXiv.org web-
5 Canada 493 site (an important source of AI research)
6 Japan 398 were not part of the search query, and pri-
7 The Netherlands 372 vate for-profit entities that sponsor medical
AI research (including medical imaging re-
8 France 365
search) tend not to publish their findings.
9 India 317 Despite these areas contributing to underes-
10 Italy 311 timation of the absolute number, we believe
11 South Korea 305 our bibliometric analysis still provides valu-
able insight into the global trend of AI radi-
12 Australia 239
ology research.
Note—Some publications are recorded in more than one country according to authorship. Other limitations include the fact that our
analysis does not account for quality of pub-
TABLE 2:  Radiology Artificial Intelligence Publications by Subspecialty lications and the fact that metrics such as
(2000–2018) impact factor were not considered. In addi-
tion, funding sources were evaluated by the
Subspecialty No. (%) of Publications (n = 8813)
number of publications produced rather than
Neuroradiology 2148 (24.4) by the monetary amount given. Although
Chest and body 1825 (20.7) productivity can be used as a marker for
American Journal of Roentgenology

funding, it does not truly reflect the amount

Nuclear medicine 1143 (13.0)
of money allocated toward research.
Breast 1056 (12.0) Exponential growth in AI radiology re-
Musculoskeletal 606 (6.9) search has occurred worldwide, with the
Cardiac 416 (4.7) United States leading overall AI research
productivity. China has made the second big-
Pediatrics 202 (2.3)
gest contribution, largely driven by unique
Interventional 178 (2.0) research infrastructure ideal for AI research
Emergency 82 (0.9) and significant government funding support.
The future success of the United States will
ernment funding agencies, including the in- in research and development among Chinese depend on continued government funding
stitutes and centers at the NIH; however, researchers [4]. and prioritization of AI radiology research
the United States has a diverse portfolio of The neuroradiology subspecialty pro- within the research community.
funding that includes both governmental and duced the most AI publications in this study.
nongovernmental agencies. With such strong This is not surprising, given that neurora- References
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publications. China’s ability to exponential- tia (Alzheimer disease), are well matched for nity? Radiologists again at the forefront of innova-
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AJR:213, December 2019 3