Artificial intelligence (AI) is transforming radiology with improved diagnostic accuracy and efficiency, but prediction uncertainty remains a critical challenge. This review examines key sources of uncertainty-out-of-distribution, aleatoric, and model uncertainties-and highlights the importance of independent confidence metrics and explainable AI for safe integration. Independent confidence metrics assess the reliability of AI predictions, while explainable AI provides transparency, enhancing collaboration between AI and radiologists. The development of zero-error tolerance models, designed to minimize errors, sets new standards for safety. Addressing these challenges will enable AI to become a trusted partner in radiology, advancing care standards and patient outcomes.