Artificial intelligence (AI) models that evaluate medical images have potential to speed up and improve accuracy of cancer diagnoses, but they may also be vulnerable to cyberattacks. In a new study, University of Pittsburgh researchers simulated an attack that falsified mammogram images, fooling both an AI breast cancer diagnosis model and human breast imaging radiologist experts. The study, published today in Nature Communications, brings attention to a potential safety issue for medical AI known as "adversarial attacks," which seek to alter images or other inputs to make models arrive at incorrect conclusions. "What we want to show with this study is that this type of attack is possible, and it could lead AI models to make the wrong diagnosis -- which is a big patient safety issue," said senior author Shandong Wu, Ph.D., associate professor of radiology, biomedical informatics and bioengineering at Pitt. "By understanding how AI models behave under adversarial attacks in medical contexts, we can start thinking about ways to make these models safer and more robust." AI-based image recognition technology for cancer detection has advanced rapidly in recent years, and several breast cancer models have U.S. Food and Drug Administration (FDA) approval.

These days, it might seem like algorithms are out-diagnosing doctors at every turn, identifying dangerous lesions and dodgy moles with the unerring consistency only a machine can muster. Just this month, Google generated a wave of headlines with a study showing that its AI systems can spot breast cancer in mammograms more accurately than doctors. But for many in health care, what studies like these demonstrate is not just the promise of AI, but also its potential threat. They say that for all of the obvious abilities of algorithms to crunch data, the subtle, judgment-based skills of nurses and doctors are not so easily digitized. And in some areas where tech companies are pushing medical AI, this technology could exacerbate existing problems.