Month: March 2025

CAC Scoring Shines at ACC 2025

Posted on by Brian Casey

The American College of Cardiology’s annual meeting is wrapping up today in Chicago, and new research into coronary artery calcium scoring has been one of cardiac imaging’s top trends at McCormick Place.

CAC scoring has been around for ages as a way to detect and quantify calcium buildup in the coronary arteries based on data from non-contrast CT scans. 

  • But it’s only been in recent years that CAC scoring has come into its own as a tool for predicting risk of mortality and major cardiac events – in some cases years before they happen. 

Clinicians are learning that they can use CT-generated CAC scores to estimate future risk and guide interventions to reduce it, such by prescribing statins or behavior modifications. 

Research presented at ACC 2025 underscored CAC scoring’s potential …

  • In the CLARIFY CAC screening program, researchers found a 6.2% rate of thoracic aneurysm, indicating a need for screening and prevention.
  • CAC scores of 0 were more common in women than men (49% vs. 23%), but there was no statistically significant difference in non-calcified plaque rates between genders.
  • Researchers found moderate accuracy (AUC range=0.60-0.73) for a method of generating CAC scores from 12-lead ECG data rather than non-contrast CT scans.
  • Bunkerhill Health’s I-CAC algorithm was used to generate automated CAC scores for 200 patients. After six months, patients with scores >400 had a 17% rate of cardiac events and 11% all-cause mortality. 
  • A commonly used measure for low-value care based on administrative claims classified too many CAC tests as inappropriate, with a positive predictive value of only 43%.
  • A case study focused on the paradox of a 59-year-old healthy triathlete with a CAC score of 780, possibly due to chronic coronary stress from high-endurance exercise. Invasive testing was deferred in favor of medical therapy due to his low cardiac risk.
  • On the other hand, a literature review of 19.4k people found no statistically significant difference in CAC scores between endurance athletes and healthy controls.
  • Non-calcified plaque in patients with CAC scores of 0 was common (26%) in residents of rural Appalachia, indicating high risk of rupture and suggesting the limitation of relying on CAC scores. 
  • A Sunday debate discussed whether CAC scoring should be added to mammography and colon cancer screening, or reserved as a decision aid. 

The Takeaway

The studies from ACC 2025 show that CAC scoring has a bright future – bright enough that it’s generating heightened interest from cardiology. New CAC scoring tools arriving on the market should improve its predictive value even more. 

Top 40 Radiology Resources

Posted on by Brian Casey

We’re pleased to announce The Imaging Wire’s updated list of top radiology resources for 2025 – the people and publications we rely on to find the most interesting medical imaging stories. 

If you’re a regular reader, you’ll notice we’ve expanded the list from 35 resources last year to 40 this year – not only does “top 40” have a nice ring to it, but a broader list better captures the amazing range of voices in the medical imaging industry.

Another major development since last year was an exodus of science and medical professionals from Twitter/X to the BlueSky platform. Some radiology thought leaders abandoned X entirely, while others have kept accounts going on both services as they wrestle with the conundrum of abandoning audiences built on Twitter over many years.

Regardless of platform, this list of top radiology resources should keep you well-informed about healthcare’s top medical specialty.

TOP RADIOLOGY SITES

From a radiology newsletter with a laser focus on AI to an educational site with thousands of radiology cases, you’re sure to find something that meets your needs from the list below.

  • AI for Radiology – A great source for news on AI, including the Project AIR testing clearinghouse.
  • CTisUs – Excellent site for radiology content run by the legendary radiologist Elliott Fishman, MD.
  • Medality Radiology Report Podcast – Medality CEO Daniel Arnold interviews the biggest names in medical imaging.
  • radHQ.net Forums – Public bulletin board that’s a great place to hear what keeps radiologists up at night. 
  • Radiopaedia – Excellent site for educational radiology content with global focus.
  • Signify Research – The best radiology market analysis, backed by actual market data.

TOP RADIOLOGY KEY OPINION LEADERS 

Radiology is fortunate to have a wealth of really smart people sharing their thoughts. Here are a few of the best.

AI and Imaging IT

Business and Vendors

  • Jan Beger – OEM executive with insightful high-level thoughts on AI.
  • Morris Panner – Imaging IT executive with cogent takes on the intersection of technology and patient care. 
  • Sebastian Schmidt – OEM executive with thought-provoking analysis of CT lung cancer screening.
  • Reza Zahiri – Detailed LinkedIn posts that deconstruct the financial positions of medical imaging vendors.

Education

Legal and Regulatory 

  • Tobias Gilk – Radiology’s conscience on MRI safety. 
  • Tom Greeson – The authority for perspectives on legal issues in radiology.
  • Hugh Harvey, MD – No better source on international AI regulation.

Practice Management and Leadership

HEALTHCARE NEWSLETTERS AND WEBSITES 

Looking to get out of the radiology niche and broaden your horizons? Check out some of these healthcare newsletters and websites.

The Takeaway

This list should cover all your bases for staying informed about the latest developments in radiology news. Or, just sign up for The Imaging Wire and we’ll do it for you.

PS – As always, if there’s any radiology influencers that should be on this list, let us know!

VC AI Funding Plummets

Posted on by Brian Casey

If you thought venture capital funding of AI firms was lower last year, you weren’t wrong. A new report from market analysis firm Signify Research found that VC funding of radiology AI firms dropped by nearly half in 2024 compared to the year before. 

VC funding has become a closely watched barometer of the radiology AI segment’s overall health. 

  • As most AI developers haven’t generated significant cash flows from product revenues yet, VC money is the oxygen that keeps AI firms breathing. 

And there are signs that after peaking in 2021, that oxygen is coming into short supply. 

  • Signify’s report last year documented a 19% drop in VC AI funding in 2023, a development attributed to tighter access to capital due to high interest rates. 

Those trends continued into 2024, with the new Signify report finding …

  • Total VC funding was $335.5M, down 48% compared to $645.6M in 2023.
  • The number of funding rounds fell 35% (20 vs. 31), to the lowest level since 2015.
  • Average deal size fell 16% ($16.8M vs. $20.1M).
  • Cleerly raised the most in 2024 with $106M in funding, followed by Qure.ai with $65M (putting Qure into Signify’s elite “$100M Club”). 
  • Funding declines were even worse in the Asia-Pacific (-84%) and the Europe, Middle East, and Africa regions (-76%) compared to the peak in 2021. 

Signify analyst Umar Ahmed noted that 2025 got off to a strong start, with $100M in funding rounds announced in January.

  • This could either represent a rebound in investor confidence, or indicate that the AI funding cycle is getting longer as VC firms put developers under the microscope and demand better ROI for their investments. 

The Takeaway

So it’s agreed that 2024 was a wash for VC radiology AI funding – what about 2025? The year’s strong start appears to have petered out as we approach the spring quarter, and ongoing regulatory turbulence and economic uncertainty in the U.S. isn’t likely to help. Stay tuned. 

How to Improve CT Lung Screening Outcomes

Posted on by Brian Casey

Getting patients to attend cancer screening exams is one of the biggest challenges in healthcare. But a new study in JAMA Network Open should provide motivation, showing that people who showed up for annual CT lung cancer screening exams had better clinical outcomes than those who didn’t. 

Low cancer screening adherence frustrates clinicians and healthcare policy experts alike, but nowhere is the situation as dire as in CT lung cancer screening.

  • U.S. lung screening adherence rates languished in the single digits for years after the exam was approved by the USPSTF, and while there has been some recent improvement, screening rates are nowhere near those of more established exams like mammography. 

At the same time, statistical modeling studies (and common sense) suggest that complying with screening would reduce lung cancer mortality. 

  • So researchers from multiple institutions in the U.S. and Canada decided to track adherence to a real-world CT lung screening program consisting of a baseline scan and then two follow-up scans roughly a year apart. 

In all, 10.2k eligible adults were screened from 2015 to 2018, with researchers finding …

  • Screening adherence rates fell from the first follow-up round to the second (61% to 51%).
  • People who attended the first follow-up round were more likely to attend the second (67% vs. 25%). 
  • Patients who completed both screening rounds had higher lung cancer diagnosis rates (1% vs. 0.2%).
  • Patients who attended the second round and got a lung cancer diagnosis were more likely to have early-stage disease (73% vs. 25%) and less likely to have late-stage disease (21% vs. 58%). 

In analyzing the results, researchers said the drop-off in adherence rates between the first and second follow-up screening rounds represented an opportunity to reach out to people who missed the first round and get them to the second.

  • This position dovetails with other recent research underscoring the importance of patient navigators in guiding eligible people to lung cancer screening. 

The Takeaway

So as radiology and other disciplines look to build on the momentum behind CT lung cancer screening, what’s the key to success in improving patient outcomes? Sometimes, it’s just getting people to show up. 

New Mammography AI Insights

Posted on by Brian Casey

Breast screening is becoming one of the most promising use cases for AI, but there’s still a lot we’re learning about it. A new study in Radiology: Artificial Intelligence revealed new insights into how well mammography AI performs in a screening environment. 

As we’ve reported in the past, mammography is one of radiology’s most challenging cancer screening exams, with radiologists sorting through large volumes of normal images before encountering a case that might be cancer.

In the new study, researchers applied Lunit’s Insight MMG algorithm to mammograms in a retrospective study of 136.7k women screened in British Columbia from 2019 to 2020. 

  • Canada uses single reading for mammography, unlike the double-reading protocols employed in the U.K. and Europe. 

AI’s performance was compared to single-reading radiologists using various metrics and follow-up periods, finding … 

  • At one-year follow-up, AI had slightly lower sensitivity (89% vs. 93%) and specificity (79% vs. 92%) compared to radiologists.
  • At two-year follow-up, there was no statistically significant difference in sensitivity between the two (83.5% vs. 84.3%, p=0.69). 
  • AI’s overall AUC at one year was 0.93, but this varied based on mammographic and demographic features, with AI performing better in cases with fatty versus dense breasts (0.96 vs. 0.84) and cases with architectural distortion (0.96 vs. 0.92) but worse in cases with calcifications (0.87 vs. 0.92).

The researchers then constructed hypothetical scenarios in which AI might be used to assist radiologists, finding …

  • If radiologists only read cases ruled abnormal by AI, it would reduce workload by 78%, but at a price of reduced sensitivity (86% vs. 93%) and 59 missed cancers across the cohort.

It’s worth noting that Insight MMG is designed to analyze 2D digital mammography exams.

The Takeaway

While the new findings aren’t a slam dunk for mammography AI, they do provide valuable insight into its performance that can inform future research, especially into areas where AI could use improvement. 

AI Helps Radiologists Read Prostate MRI

Posted on by Brian Casey

MRI is changing how prostate cancer is detected, diagnosed, and followed up. But even a technology as powerful as MRI could use a little help, as evidenced by a new study in Radiology showing that a commercially available AI algorithm could help radiologists diagnose clinically significant prostate cancer. 

Workup of suspicious prostate lesions is being reshaped by MRI in meaningful ways.

  • For example, MRI-guided biopsy is replacing systemic prostate biopsy without guidance, especially for patients with low to intermediate risk of prostate cancer. 

But prostate MRI isn’t perfect – yet. Radiologist performance can vary due to differences in experience, as well as variations in MRI acquisitions, tumor location, and cancer prevalence. Could AI help even out these variations? 

  • To find out, researchers from South Korea tested Siemens Healthineers’ syngo.via Prostate MR algorithm in 205 patients suspected of prostate cancer who were scheduled for biopsy based on clinical information (including previous MRI scans).

The AI algorithm’s performance was compared to that of experienced radiologists, and researchers also estimated its impact on radiologist interpretation if used as a reading aid, finding that for clinically significant prostate cancer… 

  • AI had lower sensitivity versus radiologists (80% vs. 93%).
  • But higher positive predictive value (58% vs. 48%).
  • Adding AI to radiologists’ interpretation more than doubled specificity (44% vs. 21%).
  • There were no cancer cases among lesions rated by both the algorithm and radiologists as not likely to be cancer (PI-RADS 1 or 2).

AI’s higher PPV indicates that it could help reduce unnecessary prostate biopsies, while also detecting clinically significant cancer that might have been missed by radiologists.  

The Takeaway

The new findings echo previous studies that demonstrate the value of AI for MRI of prostate cancer, but differ in that they investigate a commercially available algorithm – indicating that tools for better prostate MRI are becoming accessible to radiologists. 

More Radiologists Working for PE Practices

Posted on by Brian Casey

The share of U.S. radiologists working for practices owned by private equity has skyrocketed over the past decade, from 1% in 2013 to 12% in 2023. That’s according to a new study in AJR that documents the growing trend of PE ownership in medical imaging. 

As we reported recently, the growing number of private equity acquisitions in healthcare has raised questions about PE’s impact on patient care.

  • In radiology, some industry observers worry that PE acquisitions are changing the specialty in fundamental ways, turning radiologists from owner-stakeholders into corporate employees.

The new study analyzed PE acquisitions from 2013 to 2023, with a specific focus on geographic variations. 

  • Researchers found 151 PE acquisitions of radiology practices in the U.S. over the 11-year study period, through December 2023. 

Key findings were broken down as follows…

  • The share of radiologists working for PE practices boomed (12% from 1%). 
  • PE-acquired practices were associated with 16% of all U.S. radiology locations.
  • The states with the highest shares of PE-employed radiologists were Nevada (47%), Arizona (44%), Alaska (29%), Texas (27%), and Florida (24%).
  • Companies accounting for the largest number of PE-employed radiologists were Radiology Partners (70%), LucidHealth (8%), and U.S. Radiology Specialists (7%).

The new findings echo previous research showing PE’s geographic penetration to be greatest in the West and Southeast. 

  • They also underline the extent to which Radiology Partners dominates PE acquisitions as it brings independent imaging practices under its umbrella. 

The Takeaway

The new study – along with other recent research – demonstrates the extent to which private equity acquisitions are changing the face of radiology. Researchers should take the next step and investigate PE’s impact on radiologists’ career satisfaction, and by extension, patient care. 

Has Breast Cancer Mortality Bottomed Out?

Posted on by Brian Casey

The decades-long decline in breast cancer mortality has been lauded as a major public health success story. But a new study in Journal of Breast Imaging suggests that the long decline in breast cancer death rates may be coming to an end, at least for some women.

Breast cancer mortality’s drop has been well-documented, with studies estimating the drop to range between 44% to 58% over the last three to four decades – saving at least 500k lives. 

  • Most experts believe the breast cancer mortality decline has been driven by a combination of organized mammography screening and better cancer treatments.

But amid the success are disturbing signs. Cancer incidence rates are increasing for women younger than 40 – the established starting age for screening. 

  • Mammography screening also has seen disparities in care that have resulted in higher incidence and death rates for women of color. 

In the new study, researchers examined U.S. data for breast cancer mortality from 1990 to 2022, finding that over the study period breast cancer mortality …

  • Fell by 44% for women of all ages and ethnicities over the full study period.
  • Decreased by -1.7% to -3.3% annually from 1990 to 2010, but the decline slowed to -1.2% a year from 2010 to 2022. 
  • Declined -2.8% per year for women 20-39 years old from 1990-2010, but showed no decline from 2010-2022.
  • Lowered by -1.3% per year for women older than 75 from 1993-2014, but showed no decline from 2013-2022. 
  • Declined for White and Black women of all ages, but not for Asian, Hispanic, and Native American women.
  • Was 39% higher for Black women compared to White women from 2004-2022.   

The authors acknowledge that much of their data pertain to women who are outside current screening guidelines. 

  • But they see this as an opportunity to revisit whether screening guidelines should be extended – especially to women 75 and older – to realize the benefits of early breast cancer detection. 

The Takeaway

The new findings on breast cancer mortality indicate that even as mammography’s successes are celebrated, more work remains to be done to ensure that breast screening’s benefits are enjoyed by as many women as possible. 

ECR 2025 Video Highlights

Posted on by Brian Casey

The theme of ECR 2025 was Planet Radiology, and those who were in attendance at Austria Center Vienna last week witnessed the role that radiology can play in reducing medical imaging’s contribution to climate change.

As always, ECR 2025 was the focus of cutting-edge research in AI, as well as the latest findings in traditional applications like cancer screening.

In this special edition of The Imaging Wire newsletter, we offer a recap of our ECR 2025 videos with thought leaders and imaging vendors from the exhibit floor. 

We hope you enjoy watching our ECR 2025 videos as much as we enjoyed producing them! 

Check out the ECR 2025 videos below or visit the Shows page on our website, and keep an eye out for our next Imaging Wire newsletter on Thursday.

Screening Takes Center Stage at ECR 2025

Posted on by Brian Casey

New advances in cancer screening were among the major trends at last week’s ECR 2025 conference in Vienna. From traditional screening exams like mammography to up-and-coming tests like CT lung cancer exams, radiologists are emerging at the forefront of efforts to improve population health through early detection.

CT lung cancer screening is gaining momentum in Europe, and a Friday afternoon session explored the experiences of multiple sites…

  • U.K. researchers used DeepHealth’s Lung Nodules AI solution for automated triage of lung nodules found on non-screening CT chest exams, finding the approach could save £25k-£37k annually.
  • A German team documented technical lung CT acquisition parameters for screening centers in the SOLACE consortium across 10 countries, finding some room for improvement. 
  • Preliminary results from an Italian lung screening project were reported, with 2k people scanned with a 1.5% cancer detection rate (77% stage I-II) and 17% recall rate. Smoking cessation advice was also given.
  • Early results from a pilot screening project in Poland were given, with a 1.9% cancer detection rate in 3.1k people screened. They recommend screening be implemented nationwide. 
  • In a secondary analysis of 23.4k people in the NLST study, CT-derived body composition metrics predicted mortality beyond traditional risk factors.

Meanwhile, new ECR cancer screening research builds on the landmark accomplishments from 2024 in AI for breast screening. A Saturday afternoon session explored the progress being made…

  • German breast screening programs that deployed ScreenPoint Medical’s Transpara AI algorithm for 119k women saw their cancer detection rate grow (6 vs. 4.8 cancers per 1k) while the recall rate remained stable at around 2.5%. 
  • AI-supported double-reading in Italy for 120k women led to more breast cancers detected on baseline exams compared to subsequent screening rounds, as well as a 42% lower recall rate.
  • Patients found an AI chatbot based on GPT-4 generated responses to their questions that were more empathetic and readable than those of radiologists.
  • Another Italian study found that using AI for double-reading mammograms of 266k women led to a 21% increase in cancer detection rate and 15% drop in recall rate.
  • A secondary analysis of the MASAI trial suggested that double-reading with two radiologists continue to be used for high-risk women. Single reading of 3.8k high-risk exams resulted in 8.9% fewer detected cancers and 5.9% fewer recalls.

The Takeaway

Last week’s research on cancer screening at ECR 2025 shows that imaging experts see screening as a way to not only improve population health on a broad scale, but also to give radiologists the opportunity to raise their profile with patients and take a more direct role in patient care. The question is whether it’s an opportunity radiologists are ready to take.

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