Industry experts often ask if radiology AI will eventually outperform human specialists, making imaging faster and more accurate. But these technical debates often ignore a more urgent, human reality: the massive gap between patient access and patient understanding. We have fulfilled the legal mandate for transparency, but we have failed to provide true clarity. For a patient waiting in fear, the right to “see” their data is hollow if they cannot comprehend what that diagnosis actually means for their life.
We have built a system that champions patient autonomy — the legal and moral right to make informed decisions about our own bodies. However, this autonomy is an illusion without health literacy. Today, we grant patients immediate access to their data to satisfy transparency requirements, yet we leave them without the tools to interpret it. We are handing people the keys to a locked room without providing a light.
The first truly scalable and transformative use of AI in medical imaging may not be autonomous diagnosis. Instead, it may be the creation of a “translation layer” designed to help patients actually understand the complex information they are already receiving. This gap in comprehension is a much larger problem than many healthcare leaders currently realize.
The transparency trap
In the current landscape, patients see their results faster than ever — often before they even have the chance to speak with a clinician. The 21st Century Cures Act accelerated this shift, a move that 96% of patients support according to recent surveys. They want their results immediately, even before a doctor’s review.
However, transparency is not the same as understanding. Radiology reports were historically written by specialists for other specialists, not for patients. These documents are often overloaded with dense medical terminology, complex acronyms, and compressed clinical reasoning. This shorthand is efficient for doctors, but it is a source of anxiety for patients.
The challenge is even greater with advanced technologies like CT and MRI. These reports interweave technical physics, complex anatomy, and incidental findings in a format that assumes years of medical training. For a patient, the result isn’t empowerment; it’s a “Google-search” spiral of confusion.
The emotional cost of “waiting in the dark”
This lack of understanding doesn’t happen in a vacuum. The days between a scan and a follow-up appointment are overwhelmed by stress, particularly in oncology or neurology. Studies show that nearly half of patients experience significant anxiety while waiting for results.
When a patient logs into a portal and sees a report filled with complex terms without context, they aren’t just looking at data — they are looking at their future through a blurred lens. This is exactly where patient-facing imaging AI becomes a necessity.
AI as a translation layer
The breakthrough today isn’t that AI is ready to diagnose patients independently — it is not. Rather, medical models are becoming sophisticated enough to act as a linguistic bridge. Recent advancements, such as Google’s MedGemma 1.5 expand beyond 2D images to interpret three-dimensional CT and MRI volumes. These models can generate plain-language summaries and answer specific anatomical questions.
This shift suggests that AI is moving toward supporting the patients. Instead of asking: “will AI replace radiologists”, we should ask: “how can we build a patient explanation layer that provides context when a doctor isn’t yet available?”.
Such a layer could:
- Translate jargon: Convert technical terms into everyday language.
- Answer follow-ups: Address immediate questions about anatomy and next steps.
- Prepare the patient: Help individuals formulate informed questions for their doctors, making their limited face-to-face time far more productive.
Supporting the clinician workflow
This isn’t just about patient comfort; it’s about burn-out prevention, the survival of the clinical workforce. The immediate release of results has triggered a surge in patient messages sent within hours of a report being posted.
If we open the “front door” to raw data, we must invest in the explanatory infrastructure behind that door. A safer, more human approach is to use AI as an education layer that sits alongside, not instead of, the official report. This requires strict rules: the AI must be transparent about uncertainty, avoid giving direct treatment advice, and always flag findings that require urgent human follow-up.
Photo: athima tongloom, Getty Images
Peter Nemeth is the founder of ReadYourLab, an enterprise software architect, and a cancer survivor. His work focuses on how AI can help patients better understand complex CT and MRI findings and prepare for more informed conversations with their doctors.
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