# Image fraud in nuclear medicine research

## TL;DR

A survey of nuclear medicine researchers reveals that image fraud is relatively common, driven by pressures to publish and aesthetic expectations, and suggests stronger policies and cultural changes are needed.

## Contribution

This study provides novel insights into the prevalence and drivers of image fraud in nuclear medicine research through a large-scale survey of researchers.

## Key findings

- 13.7% of respondents admitted to falsifying medical images in the past five years.
- 38.7% reported witnessing colleagues engage in image fraud practices.
- Respondents suggested stricter policies and AI tools as potential solutions to prevent image fraud.

## Abstract

To assess nuclear medicine researchers’ experiences and attitudes toward image fraud, as well as their perspectives on preventive measures.

This survey targeted corresponding authors who published in three nuclear medicine journals between 2021 and 2024. Participants were asked about their experiences related to medical image fraud, as well as their views on its prevalence, causes, and potential preventive measures.

Of the 2,837 corresponding authors invited, 284 (10.0%) completed the survey. Most of the 284 respondents were mid-career European male MDs with over 10 years of research experience. While 91% reported never feeling pressured to falsify medical images, 13.7% admitted doing so in the past five years, and 38.7% had witnessed colleagues engaging in such practices. Common forms included cherry-picking, unauthorized image reuse, and misleading enhancements. In the past five years, 1.1% admitted using AI to falsify medical images, while 2.8% reported witnessing colleagues do so. No demographic factors were significantly associated with misconduct. Key drivers cited were publication pressure, competition, and aesthetic expectations. Respondents emphasized the need for greater transparency, oversight, and cultural change. Current safeguards were generally considered ineffective. Stricter policies, increased awareness, and AI tools were suggested as potential solutions.

Image fraud in nuclear medicine research appears to be relatively prevalent. It is more frequently witnessed among other colleagues than self-reported by individual researchers. The findings highlight the need to fostering a culture of research integrity and for stronger preventive measures, including greater awareness, stricter journal policies, and improved control.

The online version contains supplementary material available at 10.1007/s00259-025-07515-5.