Keeping Pace with Volume: 7 Strategies from ASNR 2025

This week weary neuroradiologists descended upon the City of Brotherly Love for the annual meeting of the American Society of Neuroradiology (ASNR). The field is facing mounting pressure as increasing imaging volumes continue to outstrip radiologists’ capacity. 

Dealing with growing volume was a recurring theme throughout ASNR 2025, with a range of proposed solutions, including the seven strategies below:

  1. Acquisition automation for higher efficiency and reduced technical requirement: A talk by Lawrence Tanenbaum, MD, featured a number of AI solutions to ease technologist training requirements, including smart protocoling, automated patient positioning, one-touch exams without parameter adjustments, and on-device quality assurance and motion correction to cut down repeat exams.
  2. Accelerated acquisitions as the standard-of-care: Every manufacturer – from established vendors to emerging startups – showcased deep learning-based reconstruction. As Suzie Bash, MD, put it, “Deep learning reconstruction is becoming standard-of-care across the industry.”
  3. Improving radiologist reading efficiency with AI and workflow management: A noticeable trend at ASNR 2025 was fewer talks focused solely on algorithm accuracy and more emphasis on how AI impacts reading efficiency. Accuracy remains critical, but adoption increasingly hinges on demonstrating workflow efficiency.
  4. Streamlining new algorithm rollout using integrated platforms: In a session on AI adoption and evaluation, Reza Forghani, MD, PhD, called for increased use of integrated platforms to allow for easier algorithm deployment, validation, and monitoring.
  5. Rising reliance on international medical graduates (IMGs): Mina Hesami, MD, presented on the rising contribution of IMGs to US radiology, noting a steady increase in the proportion of residency slots, fellowships, and leadership roles held by international graduates – with radiology seeing faster growth than most other medical specialties.
  6. Expanding the radiology workforce with mid-level providers: Another proposed strategy is offloading specific tasks to mid-level providers. While still controversial in radiology, this model is gaining traction in response to workforce shortages.
  7. Sustainability by reducing emissions and environmental impact: Several ASNR sessions addressed environmental sustainability. From simply turning off idle scanners to using AI to reduce contrast doses, radiologists are beginning to reckon with the environmental impact of rising scan volumes.

The Takeaway

The sessions at ASNR 2025 indicate that while there’s a lot of buzz around AI, radiologists are considering every tool at their disposal to keep up with rising imaging volumes. AI will play a role, but likely won’t be sufficient alone to keep up with increasing volumes.

T. Campbell Arnold is a research scientist at Subtle Medical and the managing editor of RadAccess.

Imaging Workload Jumps with Higher Use of CT, MRI

Radiology’s shift to more advanced modalities like CT and MRI is increasing the burden on radiologists to interpret more complex exams. A new study in JACR documents the trend, finding that radiologist workload for inpatient imaging has risen sharply over the last 10 years. 

Like many physicians, radiologists are feeling burned out from rising patient workload, personnel shortages, and declining reimbursement. 

  • But radiology has the added burden of being one of healthcare’s most technology-focused specialties, with new imaging modalities giving them cooler tools to work with, but at the cost of steadily increasing exam complexity.

Researchers from Brigham and Women’s Hospital have been tracking inpatient imaging utilization for the past 40 years, and the new paper provides the latest update. 

  • They calculated inpatient imaging volume at Brigham and Women’s from 2012 to 2023, during which 896k imaging exams were performed.  

Results for the study were as follows …

  • Total annual inpatient imaging volume grew 17% over 10 years (102k to 119k exams).
  • Total imaging exams per patient admission (adjusted by case mix and disease severity) fell 20% due to declines in X-ray, ultrasound, and nuclear medicine.
  • But imaging exams per patient admission grew for CT (19%) and MRI (21%).
  • Leading to growth in CT and MRI’s combined share of all radiology global RVUs (62% to 75%).
  • Hospital length of stay rose 32% (5.6 to 7.4 days), possibly due to the COVID-19 pandemic. 

What does it all mean? Basically, the number of inpatient imaging exams per patient is declining when adjusted for disease severity, but radiologists are still having to work harder because the studies are more complex. 

  • Imaging could also be shifting from the inpatient setting to outpatient centers due to reimbursement changes aimed at shifting exams to lower-cost settings than hospitals.

One big question with the new study is the degree to which the COVID-19 pandemic skewed the results compared with previous years. 

  • The pandemic may have spurred more use of CT, especially given its value in providing a definitive diagnosis of SARS-CoV-2 infection. 

The Takeaway

If you feel like you’re working harder than ever, the new findings show that you’re not crazy. And given radiology’s breakneck pace of innovation, it’s not likely the trends revealed in the new study will let up any time soon.

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