There’s no question that 2025 will be a watershed year for radiology. AI is on the cusp of going mainstream, the radiologist shortage won’t go away, and a number of new U.S. regulatory initiatives promise to reshape the field.
As we did in 2024, The Imaging Wire asked key opinion leaders in medical imaging to provide their predictions on the technologies, clinical applications, and regulatory developments that will shape the specialty for the next 12 months.
AI Blurs Lines with Generative Models: “Providers will interchangeably use both general-purpose and custom-built GenAI models for regulated (e.g., draft reporting) and unregulated (e.g., EHR summaries) tasks. This will blur current lines for medical device determination, shift performance testing from regulators to providers, and encourage regulators to define comprehensive clearance pathways for GenAI.” – Keith Dreyer, DO, PhD, and Bernardo Bizzo, MD, PhD, Mass General Brigham/Harvard Medical School
AI Focus on Reporting and Synthetic Data: “There will be continued interest in using generative AI for reporting and synthetic data alongside ongoing discussions about bias, fairness, and regulations. We can expect an increasing focus on automated draft report generation. I look forward to seeing the community explore radiology use cases for test-time compute and agentic AI.” Woojin Kim, MD, CMIO, Rad AI
Breast Density Reporting Now in Effect: “The FDA ‘dense breast’ reporting standard is now in effect; needed next is standardization of insurance coverage. Individual state insurance laws are inconsistent, and while a federal Find It Early Act did not pass in 2024, supporters will likely reintroduce the legislation in 2025 to ensure health plans cover screening/diagnostic breast imaging with no out-of-pocket costs for women with dense breasts or at higher risk for breast cancer.” – JoAnn Pushkin, executive director, DenseBreast-info
Breast Screening Based on Risk: “The future direction of breast screening will likely include AI to analyze mammograms and other screening imaging studies as well as patient health data rather than family history and lifestyle choices, allowing more accurate risk assessment. Patients will receive tailored screening recommendations, and imaging may include breast MRI, DBT with AI assistance, and other technologies to identify small high-grade aggressive tumors. Genetic testing results will help identify patients at high elevated risk, providing patients with accurate, clear information about their individual risk and engaging them with shared decision-making regarding benefits and harms of screening opportunities.” – Stamatia Destounis, MD, managing partner, Elizabeth Wende Breast Care
MRI Safety Comes of Age: “2025 will be the year of MRI safety’s ‘coming of age.’ New CPT codes to reimburse providers for the additional effort required to ensure safe scanning of patients with implants are the first time a formal structure has been established to ensure at least some MRI safety. This CPT change isn’t a stand-alone revolution, but a bellwether of the ‘young adulthood’ of MRI safety and changes yet to come.” Tobias Gilk, founder, Gilk Radiology Consultants
New Era for CT Colonography: “A new era for CT colonography started on January 1, 2025, when CMS started coverage for colorectal cancer screening. Adding CTC as an option for CRC screening will ultimately save lives since it identifies precursor polyps as well as cancer. Expanding screening CTC to some of our most vulnerable patients – including African Americans, who have higher rates of colorectal cancer – will help to improve health disparities. Radiologists need to be prepared to handle increased CTC volumes to assure efficient and effective patient care.” – Judy Yee, MD, Montefiore Medical Center/Albert Einstein College of Medicine
Patients Discover AI for Medical Images: “Patients will use consumer-grade, multi-modal generative AI chatbots like ChatGPT to interpret their medical images and verify radiology reports for missed findings. Because they are not marketed for medical use, regulators will struggle to enforce oversight and could announce enforcement discretion for consumer use of these general-purpose AI models.” – Keith Dreyer, DO, PhD, and Bernardo Bizzo, MD, PhD, Mass General Brigham/Harvard Medical School
Radiologist Shortage Deepens: “Maintaining proper staffing to support increasing volume will be the number one priority for private practices with hospital-based services in 2025. The shortage of radiologists is deepening, and with the demand for staffing growing so is the compensation package necessary to attract candidates. Private practices serving hospitals with weaker payor mix profiles will continue to seek financial support from their hospital partners to remain competitive in the market, not only to recruit new radiologists but also to retain current staff.” – Daniel Corbett, chief of business development, Radiology Business Solutions
Radiology in the Spotlight – for Better or Worse: “2025 will be the first year of Trump 2.0. Elon Musk and Vivek Ramaswamy will be busy beavering through the federal government. All attention will be on healthcare costs again. Radiology will be in the spotlight with calls to curb utilization, adopt AI, abolish fee-for-service, and adopt alternative payment models.” – Saurabh Jha, MBBS, AKA RogueRad, Hospital of the University of Pennsylvania
Radiology’s Tough Economy Triggers Action: “I expect the global imaging market to look quite different at the end of 2025 versus the start, as tough economic conditions trigger action: M&A of small and mid-size hardware innovators; consolidation in imaging AI with category leaders emerging; the growing influence of non-imaging actors (pharma and life sciences, imaging service providers, big tech); price competition biting for the largest hardware vendors in emerging markets; and speculatively, at least one multi-billion top 20 vendor ‘mega-merger.’ Buckle up!” – Steve Holloway, CEO, Signify Research
Regulation and Reimbursement: “Reimbursement decreases and recruitment challenges persist in 2025. While it remains critical that radiologists continue to advocate for the specialty and diversify their business plans, it’s becoming increasingly important for hospital-based groups to understand the fair market value of their services and potentially negotiate for additional support.” – Sandy Coffta, VP of client services, Healthcare Administrative Partners
Reimbursement Aids Nuclear Medicine Access: “In 2025, CMS reimbursement policy adjustments are expected to increase nuclear medicine usage and patient access. Ongoing clinical trials will likely drive approval of new radiopharmaceutical therapies and theranostics. With the radiopharmaceutical market projected to reach $12.4B, we expect improved access to nuclear medicine diagnostics and treatments in oncology, neurology, and cardiac imaging.” – Cathy Sue Cutler, PhD, SNMMI president and chair/Brookhaven National Laboratory
The Takeaway
Making predictions is never easy, and that’s particularly true in a discipline as dynamic as radiology. Whatever happens in 2025, you’ll be sure to read all about it in The Imaging Wire.
