Radiologists Miss Many AI-Generated Chest X-Rays in Blinded Study, Especially Image-Conditioned Ones

In a blinded reader study, radiologists detected only 34.0% of image-conditioned synthetic chest radiographs vs 56.1% of text-only generated ones, showing GenAI can create visually authentic fakes.

• Synthetic images from GPT-image were less frequently detected than those from Gemini-image and showed higher perceptual similarity to real conditioning radiographs.
• Paired comparison with the original normal radiograph improved detection of previously missed image-conditioned synthetic images.

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