Image fraud in nuclear medicine research.

PURPOSE To assess nuclear medicine researchers' experiences and attitudes toward image fraud, as well as their perspectives on preventive measures. METHODS 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. RESULTS 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. CONCLUSIONS 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.