{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:13:56Z","timestamp":1790730836781,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004242","name":"Princess Nourah Bint Abdulrahman University","doi-asserted-by":"publisher","award":["PNURSP2026R110"],"award-info":[{"award-number":["PNURSP2026R110"]}],"id":[{"id":"10.13039\/501100004242","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Traditional anatomical resources like cadaveric dissection and professional atlases are the gold standard, but face constraints in cost and accessibility. The rapid integration of generative artificial intelligence (AI) in medical education offers new possibilities for custom anatomical illustration. Text\u2010to\u2010image AI generators provide an inexpensive and swift alternative for medical illustration. However, the anatomical fidelity and educational reliability of these models remain insufficiently validated. This study aimed to evaluate the accuracy of four prominent AI image generators in producing anatomically correct illustrations of the human heart, kidney, and brain. Four AI platforms\u2014Copilot, Microsoft Designer, Gemini, and Freepik\u2014were prompted to generate high\u2010resolution, textbook\u2010style illustrations of the heart (sternocostal view), kidney (coronal cross\u2010section), and brain (lateral view). A total of 12 selected images were evaluated by a radiologist and two anatomists utilizing a structured 5\u2010point Likert scale across five domains: textural realism, topological validity, morphometric accuracy, perspective and depth perception, and educational utility. Significant variability in performance was observed across platforms. Gemini consistently demonstrated superior performance, achieving perfect intraclass correlation coefficients (ICCs) and the highest ratings on complex topological tasks, including the representation of coronary vasculature and cortical sulci\/gyri. Copilot showed high spatial accuracy in renal hilum organization. While all platforms showed high reliability and accuracy across broad morphological shapes (aortic arch, cerebral poles), accuracy declined sharply as anatomical complexity increased. AI\u2010generated anatomical illustrations currently vary from medically indistinguishable to biologically impossible. While Gemini and Copilot show promise for supplemental educational use, the high frequency of hallucinated anatomical details in other platforms poses a risk for medical misinformation. The study underscores the necessity for expert supervision and for developing AI models trained on curated, peer\u2010reviewed medical datasets.<\/jats:p>","DOI":"10.1002\/ca.70177","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T07:55:12Z","timestamp":1783151712000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Anatomical Fidelity in Text\u2010to\u2010Image Generative\n                    <scp>AI<\/scp>\n                    : A Comparative Qualitative and Quantitative Evaluation"],"prefix":"10.1002","author":[{"given":"Emad A.","family":"Albadawi","sequence":"first","affiliation":[{"name":"Department of Basic Medical Sciences College of Medicine, Taibah University  Madinah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8518-7641","authenticated-orcid":false,"given":"Eman M.","family":"Embaby","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Veterinary Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid I.","family":"AlQumaizi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences College of Medicine, AlMaarefa University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manar Abd Elaziz","family":"Elsaid","sequence":"additional","affiliation":[{"name":"Radiology Department  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal F.","family":"Dawood","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences College of Medicine, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6589-4514","authenticated-orcid":false,"given":"Mamdouh","family":"Eldesoqui","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences College of Medicine, AlMaarefa University  Riyadh Saudi Arabia"},{"name":"Research Center, Deanship of Scientific Research and Post\u2010Graduate Studies AlMaarefa University  Dariyah Saudi Arabia"},{"name":"Department of Human Anatomy and Embryology, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.30574\/wjarr.2024.21.1.0165","article-title":"Comparative Effectiveness of Cadaveric Dissection Versus Anatomical Models in Teaching Anatomy: A Global Analysis Focused on Medical Schools in Low and Middle\u2013Income Countries Versus High\u2010Income Countries: A Systematic Review","volume":"21","author":"Ajemba M. N.","year":"2024","journal-title":"World Journal of Advanced Research Reviews"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"24412","DOI":"10.1109\/ACCESS.2024.3365043","article-title":"Text\u2010to\u2010Image Synthesis With Generative Models: Methods, Datasets, Performance Metrics, Challenges, and Future Direction","volume":"12","author":"Alhabeeb S. K.","year":"2024","journal-title":"IEEE Access"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1080\/17453054.2025.2504491","article-title":"Comparison of Anatomy Image Generation Capability in AI Image Generation Models","volume":"48","author":"Bae J. S.","year":"2025","journal-title":"Journal of Visual Communication in Medicine"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.4103\/amsr.amsr_27_23","article-title":"Competency\u2010Based Medical Education: An Overview","volume":"2","author":"Bhattacharya S.","year":"2023","journal-title":"Annals of Medical Science Research"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1152\/advan.00182.2017","article-title":"Question Order and Student Understanding of Structure and Function","volume":"42","author":"Carter K. P.","year":"2018","journal-title":"Advances in Physiology Education"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.59324\/ejaset.2025.3(4).16","article-title":"Generative Artificial Intelligence in Healthcare: A Systematic Review of GANs, Diffusion Models, Large Language Models, and Variational Autoencoders for Medical Applications","volume":"3","author":"Chataut S.","year":"2025","journal-title":"European Journal of Applied Science, Engineering and Technology"},{"key":"e_1_2_9_8_1","first-page":"123","volume-title":"Illustration","author":"Demir H.","year":"2026"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","DOI":"10.3390\/a18030155","article-title":"Text\u2010Guided Synthesis in Medical Multimedia Retrieval: A Framework for Enhanced Colonoscopy Image Classification and Segmentation","volume":"18","author":"Ejiga Peter O. O.","year":"2025","journal-title":"Algorithms"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1002\/ca.70002","article-title":"Assessing the Anatomical Accuracy of AI\u2010Generated Medical Illustrations: A Comparative Study of Text\u2010To\u2010Image Generator Tools in Anatomy Education","volume":"38","author":"Eldesoqui M.","year":"2025","journal-title":"Clinical Anatomy"},{"key":"e_1_2_9_11_1","unstructured":"Hunter S.2021.\u201cClinical Anatomy Remote Learning: A Multimethod Study of Actual and Perceived Anatomical Knowledge.\u201d"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/ca.24272","article-title":"The Roles of Artificial Intelligence in Teaching Anatomy: A Systematic Review","volume":"38","author":"Joseph T. 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J.","year":"2019","journal-title":"BMC Medicine"},{"issue":"9","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.landig.2025.100890","article-title":"Exploring the Potential of Generative Artificial Intelligence in Medical Image Synthesis: Opportunities, Challenges, and Future Directions","volume":"7","author":"Khosravi B.","year":"2025","journal-title":"Lancet Digital Health"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","DOI":"10.1080\/10872981.2024.2304973","article-title":"Challenge, Integration, and Change: ChatGPT and Future Anatomical Education","volume":"29","author":"Leng L.","year":"2024","journal-title":"Medical Education Online"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","DOI":"10.2196\/71125","article-title":"Applications, Challenges, and Prospects of Generative Artificial Intelligence Empowering Medical Education: Scoping Review","volume":"11","author":"Lin Y.","year":"2025","journal-title":"JMIR Medical Education"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1152\/advan.00175.2016","article-title":"Structure\u2010Function Relations in Physiology Education: Where's the Mechanism?","volume":"41","author":"Lira M. 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M.","year":"2023","journal-title":"Journal of Advances in Medical Education & Professionalism"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/s41586-023-05881-4","article-title":"Foundation Models for Generalist Medical Artificial Intelligence","volume":"616","author":"Moor M.","year":"2023","journal-title":"Nature"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1002\/ase.2336","article-title":"Evaluating AI\u2010Powered Text\u2010To\u2010Image Generators for Anatomical Illustration: A Comparative Study","volume":"17","author":"Noel G.","year":"2024","journal-title":"Anatomical Sciences Education"},{"key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s00276-025-03699-5","article-title":"Text to Image Generators for Anatomical Illustrations: Potential and Limitations","volume":"47","author":"Pasli B.","year":"2025","journal-title":"Surgical and Radiologic Anatomy"},{"key":"e_1_2_9_23_1","volume-title":"AI Ethics in Practice: Navigating Academic Insight, Managerial Expertise, and Philosophical Inquiry","author":"P\u00f5der J.\u2010C.","year":"2025"},{"key":"e_1_2_9_24_1","volume-title":"Foundations of Clinical Research: Applications to Evidence\u2010Based Practice","author":"Portney L. G.","year":"2020"},{"key":"e_1_2_9_25_1","doi-asserted-by":"crossref","unstructured":"Poupard M. F.Larrue M.Bertrand D.Liguoro H.Sauz\u00e9on andA.Tricot.2025.\u201cEnhancing Anatomy Learning Through Mixed Reality\u2010Supported Drawing: Investigating Learning Performance Cognitive Load and Intrinsic Motivation.\u201d","DOI":"10.35542\/osf.io\/gzvcb_v1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"crossref","DOI":"10.2196\/48785","article-title":"Opportunities, Challenges, and Future Directions of Generative Artificial Intelligence in Medical Education: Scoping Review","volume":"9","author":"Preiksaitis C.","year":"2023","journal-title":"JMIR Medical Education"},{"key":"e_1_2_9_27_1","unstructured":"Ramesh A.2022.\u201cHierarchical Text\u2010Conditional Image Generation With CLIP Latents.\u201darXiv."},{"key":"e_1_2_9_28_1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1080\/17470919.2023.2248687","article-title":"Social Cognition in Hyperkinetic Movement Disorders: A Systematic Review","volume":"18","author":"Rizzo G.","year":"2023","journal-title":"Social Neuroscience"},{"key":"e_1_2_9_29_1","doi-asserted-by":"crossref","DOI":"10.1007\/s42979-024-03538-1","article-title":"Emerging Technologies for Global Education: A Comprehensive Exploration of Trends, Innovations, Challenges, and Future Horizons","volume":"5","author":"Samala A. D.","year":"2024","journal-title":"SN Computer Science"},{"key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"23661","DOI":"10.1007\/s11042-024-20016-1","article-title":"Generative Artificial Intelligence: A Systematic Review and Applications","volume":"84","author":"Sengar S. S.","year":"2025","journal-title":"Multimedia Tools and Applications"},{"key":"e_1_2_9_31_1","doi-asserted-by":"crossref","first-page":"631","DOI":"10.52083\/DLQJ8889","article-title":"A Comparative Analysis to Assess Anatomical Illustrations via Three AI\u2010Driven Text\u2010To\u2010Image Generators","volume":"28","author":"Sikandar A.","year":"2024","journal-title":"European Journal of Anatomy"},{"key":"e_1_2_9_32_1","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1152\/advan.00131.2023","article-title":"Development of Critical Thinking Skills in Human Anatomy and Physiology","volume":"47","author":"Silldorff E. P.","year":"2023","journal-title":"Advances in Physiology Education"},{"key":"e_1_2_9_33_1","doi-asserted-by":"crossref","DOI":"10.1007\/s00276-024-03513-8","article-title":"Reliability and Efficiency of ChatGPT 3.5 and 4.0 as a Tool for Scalenovertebral Triangle Anatomy Education","volume":"47","author":"Singal A.","year":"2024","journal-title":"Surgical and Radiologic Anatomy"},{"key":"e_1_2_9_34_1","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1002\/ca.70104","article-title":"A Comparative Study of Generative Artificial Intelligence Tools for Human Bone Learning","volume":"39","author":"Sirirat W.","year":"2026","journal-title":"Clinical Anatomy"},{"key":"e_1_2_9_35_1","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1037\/met0000516","article-title":"Updated Guidelines on Selecting an Intraclass Correlation Coefficient for Interrater Reliability, With Applications to Incomplete Observational Designs","volume":"29","author":"Ten Hove D.","year":"2024","journal-title":"Psychological Methods"},{"key":"e_1_2_9_36_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1109\/MMUL.2025.3538862","article-title":"Quality Assessment for Text\u2010to\u2010Image Generation: A Survey","volume":"32","author":"Tian Y.","year":"2025","journal-title":"IEEE Multimedia"},{"key":"e_1_2_9_37_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41591-018-0300-7","article-title":"High\u2010Performance Medicine: The Convergence of Human and Artificial Intelligence","volume":"25","author":"Topol E. J.","year":"2019","journal-title":"Nature Medicine"},{"key":"e_1_2_9_38_1","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1007\/s00276-023-03229-1","article-title":"The Potential Role of ChatGPT and Artificial Intelligence in Anatomy Education: A Conversation With ChatGPT","volume":"45","author":"Totlis T.","year":"2023","journal-title":"Surgical and Radiologic Anatomy"},{"key":"e_1_2_9_39_1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1177\/15533506241248239","article-title":"The Role of Artificial Intelligence in Medical Education: A Systematic Review","volume":"31","author":"Tozsin A.","year":"2024","journal-title":"Surgical Innovation"},{"key":"e_1_2_9_40_1","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1186\/s12909-020-02166-6","article-title":"Refuting Misconceptions in Medical Physiology","volume":"20","author":"Versteeg M.","year":"2020","journal-title":"BMC Medical Education"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.70177","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.70177","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.70177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T07:55:24Z","timestamp":1783151724000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.70177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,4]]},"references-count":39,"alternative-id":["10.1002\/ca.70177"],"URL":"https:\/\/doi.org\/10.1002\/ca.70177","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,4]]},"assertion":[{"value":"2026-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ca.70177"}}