There are lots of ways bias can still occur, like in who gets referred for scans, when they get referred, what the referrer writes on the request form, how the technologist takes the images (I could tell you some horribly racist stories about a few ultrasonographers I've worked with), and so on.

And all of this is based on previous work that AI produces bias (when trained on these datasets). If it was useful differences that drove AI learning about race, the models would not produce disparities. We went looking for how it is interacting with race because we already knew it was producing unacceptable outcomes. The big news here is that it is so easy to learn race that this effect is almost certainly not isolated to the systems tested so far.