While a certain degree of diversity in the design and implementation of AI solutions in medicine is both expected and desirable to promote innovation and differentiation, the Universality principle recommends the definition and application of standards during algorithm development, evaluation and deployment. These standards, including technical, clinical, ethical and regulatory standards, will achieve at least three key objectives: (1) They will enable the development of AI technologies with increased interoperability and applicability across clinical centres, radiology units and geographical locations; (2) they will promote a culture of quality, safety and trust in medical AI based on well-proven, widely accepted frameworks; (3) they will facilitate co-creation and cooperation in medical AI between AI developers, manufacturers, radiologists, physicians, data managers and healthcare bodies based on unified language and common approaches. For increased universality in medical AI, we propose the following recommendations: