Exploring the potential of generative artificial intelligence in medical image synthesis: opportunities, challenges, and future directions

Generative artificial intelligence has emerged as a transformative force in medical imaging since 2022, enabling the creation of derivative synthetic datasets that closely resemble real-world data. This Viewpoint examines key aspects of synthetic data, focusing on its advancements, applications, and challenges in medical imaging. Various generative artificial intelligence image generation paradigms, such as physics-informed and statistical models, and their potential to augment and diversify medical research resources are explored. The promises of synthetic datasets, including increased diversity, privacy preservation, and multifunctionality, are also discussed, along with their ability to model complex biological phenomena. Next, specific applications using synthetic data such as enhancing medical education, augmenting rare disease datasets, improving radiology workflows, and enabling privacy-preserving multicentre collaborations are highlighted. The challenges and ethical considerations surrounding generative artificial intelligence, including patient privacy, data copying, and potential biases that could impede clinical translation, are also addressed. Finally, future directions for research and development in this rapidly evolving field are outlined, emphasising the need for robust evaluation frameworks and responsible utilisation of generative artificial intelligence in medical imaging.