{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T07:28:05Z","timestamp":1766820485692,"version":"build-2065373602"},"reference-count":10,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Imperial College London"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Perianal fistulising Crohn\u2019s disease (pfCD) affects 1 in 5 Crohn\u2019s patients and requires frequent MRI monitoring. Standard radiology reports are written for clinicians using technical language often inaccessible to patients, which can cause anxiety and hinder engagement. This study evaluates the feasibility and safety of AI-generated patient-friendly MRI fistula summaries to improve patient understanding and shared decision-making. MRI fistula reports spanning healed to complex disease were identified and used to generate AI patient-friendly summaries via ChatGPT-4. Six de-identified MRI reports and corresponding AI summaries were assessed by clinicians for hallucinations and readability (Flesch-Kincaid score). Sixteen patients with perianal fistulas were randomized to review either AI summaries or original reports and rated them on readability, comprehensibility, utility, quality, follow-up questions, and trustworthiness using Likert scales. Patients rated AI summaries significantly higher in readability (median 5 vs. 2, p = 0.011), comprehensibility (5 vs. 2, p = 0.007), utility (5 vs. 3, p = 0.014), and overall quality (4.5 vs. 4, p = 0.013), with fewer follow-up questions (3 vs. 4, p = 0.018). Clinicians found AI summaries more readable (mean Flesch-Kincaid 54.6 vs. 32.2, p = 0.005) and free of hallucinations. No clinically significant inaccuracies were identified. AI-generated patient-friendly MRI summaries have potential to enhance patient communication and clinical workflow in pfCD. Larger studies are needed to validate clinical utility, hallucination rates, and acceptability.<\/jats:p>","DOI":"10.3390\/jimaging11090302","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T15:31:21Z","timestamp":1756999881000},"page":"302","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["AI-Generated Patient-Friendly MRI Fistula Summaries: A Pilot Randomised Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0852-5931","authenticated-orcid":false,"given":"Easan","family":"Anand","sequence":"first","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Itai","family":"Ghersin","sequence":"additional","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5686-8595","authenticated-orcid":false,"given":"Gita","family":"Lingam","sequence":"additional","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Theo","family":"Pelly","sequence":"additional","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Daniel","family":"Singer","sequence":"additional","affiliation":[{"name":"Tenrec Analytics, St Albans AL1 4TJ, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0903-5395","authenticated-orcid":false,"given":"Chris","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London NW1 2DA, UK"}]},{"given":"Robin E. J.","family":"Munro","sequence":"additional","affiliation":[{"name":"Patient Advocate, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"}]},{"given":"Rachel","family":"Capstick","sequence":"additional","affiliation":[{"name":"Patient Advocate, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"}]},{"given":"Anna","family":"Antoniou","sequence":"additional","affiliation":[{"name":"Patient Advocate, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"}]},{"given":"Ailsa L.","family":"Hart","sequence":"additional","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Phil","family":"Tozer","sequence":"additional","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3885-5752","authenticated-orcid":false,"given":"Kapil","family":"Sahnan","sequence":"additional","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Phillip","family":"Lung","sequence":"additional","affiliation":[{"name":"Robin Phillips\u2019 Fistula Research Unit, St Mark\u2019s The National Bowel Hospital, London NW10 7NS, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1093\/ibd\/izab287","article-title":"Epidemiology and Natural History of Perianal Crohn\u2019s Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts","volume":"28","author":"Tsai","year":"2022","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.cgh.2024.06.047","article-title":"Perianal Fistulizing Crohn\u2019s Disease: Utilizing the TOpClass Classification in Clinical Practice to Provide Targeted Individualized Care","volume":"23","author":"Hanna","year":"2025","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"otaf015","DOI":"10.1093\/crocol\/otaf015","article-title":"Patients\u2019 Attitudes to Magnetic Resonance Imaging in Perianal Fistulizing Crohn\u2019s Disease: A Global Survey","volume":"7","author":"Anand","year":"2025","journal-title":"Crohn\u2019s Colitis 360"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s12955-021-01724-w","article-title":"Does patient engagement affect IBD patients\u2019 health-related quality of life? Findings from a cross-sectional study among people with inflammatory bowel diseases","volume":"19","author":"Barello","year":"2021","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"407","DOI":"10.59249\/NKOY5498","article-title":"Artificial Intelligence to Improve Patient Understanding of Radiology Reports","volume":"96","author":"Amin","year":"2023","journal-title":"Yale J. Biol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s00256-024-04599-2","article-title":"Translating musculoskeletal radiology reports into patient-friendly summaries using ChatGPT-4","volume":"53","author":"Kuckelman","year":"2024","journal-title":"Skelet. Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Park, J., Oh, K., Han, K., and Lee, Y.H. (2024). Patient-centered radiology reports with generative artificial intelligence: Adding value to radiology reporting. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-63824-z"},{"key":"ref_8","first-page":"26","article-title":"Exploring the performance of ChatGPT-3.5 in addressing dermatological queries: A research investigation into AI capabilities","volume":"111","author":"Rojek","year":"2024","journal-title":"Dermatol. Rev. Przegl\u0105d Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s41747-024-00529-y","article-title":"Image biomarkers and explainable AI: Handcrafted features versus deep learned features","volume":"8","author":"Rundo","year":"2024","journal-title":"Eur. Radiol. Exp."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3129","DOI":"10.1038\/s41591-024-03185-2","article-title":"A generalist vision-language foundation model for diverse biomedical tasks","volume":"30","author":"Zhang","year":"2024","journal-title":"Nat. Med."}],"container-title":["Journal of Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-433X\/11\/9\/302\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:39:44Z","timestamp":1760035184000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-433X\/11\/9\/302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jimaging11090302"],"URL":"https:\/\/doi.org\/10.3390\/jimaging11090302","relation":{},"ISSN":["2313-433X"],"issn-type":[{"type":"electronic","value":"2313-433X"}],"subject":[],"published":{"date-parts":[[2025,9,4]]}}}