To delineate image data curation needs and describe a locally designed graphical user interface (GUI) to aid radiologists in image annotation for artificial intelligence (AI) applications in medical imaging. GUI components support image analysis toolboxes, picture archiving and communication system integration, third-party applications, processing of scripting languages, and integration of deep learning libraries. For clinical AI applications, GUI components included two-dimensional segmentation and classification; three-dimensional segmentation and quantification; and three-dimensional segmentation, quantification, and classification. To assess radiologist engagement and performance efficiency associated with GUI-related capabilities, image annotation rate (studies per day) and speed (minutes per case) were evaluated in two clinical scenarios of varying complexity: hip fracture detection and coronary atherosclerotic plaque demarcation and stenosis grading. For hip fracture, 1050 radiographs were annotated over 7 days (150 studies per day; median speed: 10 seconds per study [interquartile range, 3–21 seconds per study]).