Clinical use of artificial intelligence products for radiology in the Netherlands between 2020 and 2022

K. van Leeuwen, M. de Rooij, S. Schalekamp, B. van Ginneken and M. Rutten

European Radiology 2023.




To map the clinical use of CE-marked artificial intelligence (AI)-based software in radiology departments in the Netherlands (n = 69) between 2020 and 2022.

Materials and methods

Our AI network (one radiologist or AI representative per Dutch hospital organization) received a questionnaire each spring from 2020 to 2022 about AI product usage, financing, and obstacles to adoption. Products that were not listed on by July 2022 were excluded from the analysis.


The number of respondents was 43 in 2020, 36 in 2021, and 33 in 2022. The number of departments using AI has been growing steadily (2020: 14, 2021: 19, 2022: 23). The diversity (2020: 7, 2021: 18, 2022: 34) and the number of total implementations (2020: 19, 2021: 38, 2022: 68) has rapidly increased. Seven implementations were discontinued in 2022. Four hospital organizations said to use an AI platform or marketplace for the deployment of AI solutions. AI is mostly used to support chest CT (17), neuro CT (17), and musculoskeletal radiograph (12) analysis. The budget for AI was reserved in 13 of the responding centers in both 2021 and 2022. The most important obstacles to the adoption of AI remained costs and IT integration. Of the respondents, 28% stated that the implemented AI products realized health improvement and 32% assumed both health improvement and cost savings.


The adoption of AI products in radiology departments in the Netherlands is showing common signs of a developing market. The major obstacles to reaching widespread adoption are a lack of financial resources and IT integration difficulties.

Clinical relevance statement

The clinical impact of AI starts with its adoption in daily clinical practice. Increased transparency around AI products being adopted, implementation obstacles, and impact may inspire increased collaboration and improved decision-making around the implementation and financing of AI products.

Key Points

The adoption of artificial intelligence products for radiology has steadily increased since 2020 to at least a third of the centers using AI in clinical practice in the Netherlands in 2022.

The main areas in which artificial intelligence products are used are lung nodule detection on CT, aided stroke diagnosis, and bone age prediction.

The majority of respondents experienced added value (decreased costs and/or improved outcomes) from using artificial intelligence-based software; however, major obstacles to adoption remain the costs and IT-related difficulties.