Do Hospitals keep radiological images? Are they researching this stuff? Presumably they'd have a large enough sample size.
Getting images is one thing. Getting labels is harder. Getting annotations on regions-of-interest is yet harder. Often the labels are stuck in unstructured data (notes.)
When I was doing my startup (https://www.dochuddle.com/) we trained our classifier and object detector on 1.2 million images. We worked with a large sovereign on getting the images, reports, and annotations.
Just dealing with 20+ TB of images was a job in its-self...but it was indeed unreasonably effective. The success was only technical and ML success.
Even harder -- commercializing it effectively after accounting for legal/contract costs. Yet harder -- getting past conflicts of interest inherent in the US medical system. We were not successful on this front. Possibly too early (we started in 2014)
I'd disagree this is due to privacy. IMHO it is due to conflicts of interest in major medical systems (certainly in the US) where incentives are skewed away from efficiency towards more billing.
When I was CTO of DocHuddle (ML + Radiology), we reviewed every paper and preprint we could find and a huge number appeared to be overfit on tiny datasets.
Any meta-study which doesnt throw away obviously poor attempts will find bad-skewed meta-findings.