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Who’s Reading Office-Based Images? | Surge Staffing
April 3, 2025
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Together with
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“The FDA as we’ve known it is finished, with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed.”
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Former FDA Commissioner Robert Califf, MD, on this week’s FDA layoffs.
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Healthcare providers are shifting to cloud-based enterprise imaging to take advantage of its many benefits, from cybersecurity to IT staffing. In this edition of The Imaging Wire Show, we talked to Kyle Souligne and Scott Boutilier of AGFA HealthCare about the shift.
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Non-radiologist providers are reading almost half of medical images acquired in the office practice setting. A new analysis in AJR raises questions about both the quality of these interpretations as well as whether they are contributing to imaging overutilization.
Radiologists have jealously guarded their role as the primary interpreters of medical images, but keeping referring physicians away is like holding back the tide – especially when they control the patients.
- Progress was made in the 1990s with the passage of Stark legislation prohibiting doctors from referring patients to sites where they have a financial interest, but Stark includes an exemption for imaging performed in the doctors’ own offices.
This in-office exemption is a loophole big enough to drive a truck through, and as in-office imaging has grown radiologists have raised questions about:
1. Whether non-radiologist providers have adequate training in image interpretation.
2. If the economic incentive behind in-office imaging contributes to imaging overutilization.
So to learn more about who’s reading in-office images, researchers from the ACR’s Harvey L. Neiman Health Policy Institute analyzed 1.6M office-based imaging studies from 2022, discovering …
- 44% of office-based medical images are self-interpreted by the provider who ordered them.
- Self-interpretation rates varied by modality: ultrasound (52%), X-ray (50%), nuclear medicine (40%), MRI (6.1%), and CT (5.3%).
- As well as by specialty: orthopedic/sports medicine (76%), cardiology (73%), non-physician providers (31%), primary care (20%), and other specialties (38%).
- Larger practices had lower self-interpretation rates, as did practices with a radiologist on-staff.
High image self-interpretation rates could be a patient care issue given that – other than cardiology – non-radiologist physicians don’t usually receive extensive training in image interpretation.
- Imaging overutilization could also be occurring as there are no reimbursement restrictions on in-office self-referring physicians, and studies have shown that the Stark laws failed to achieve reductions in self-referred imaging volumes.
The Takeaway
The new study sheds light on one of healthcare’s most persistent problems – in-office physician self-referral. The question is whether it’s a problem that will eventually take care of itself as healthcare consolidation leads to larger medical practices that are more likely to have radiologists on staff.
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The Transformative Role of AI in Radiology
In this episode of The Radiology Report Podcast, Medality’s Daniel Arnold sits down with Dr. John Simon, who shares his insights into the transformative role of AI in radiology and its ability to enhance efficiency, improve patient care, and unlock new diagnostic possibilities.
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MRI That’s Lighter, Faster, and Sharper
Rise above and experience MRI excellence with Philips BlueSeal, the industry’s lightest, vent pipe-free, high-performance, helium-free 1.5T scanner. Watch this video to see how it can benefit your practice.
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- Surge Staffing Boosts Productivity: You’ve heard about surge pricing for rideshare services, but how about surge staffing for radiologists? In a JACR paper, researchers discuss a surge staffing model where non-scheduled radiologists were called to read exams when imaging volume spiked. In a comparison over two 60-day periods, surge staffing increased total RVU productivity 15% (44.6k vs. 38.7k) while maintaining median report turnaround times (73 vs. 74 minutes) and RVUs per person hour (8.2). Staff preferred short on-call interval surges over additional scheduled shifts.
- Lung Screening Outreach: There’s good news and bad news in a recent JAMA research letter comparing CT lung cancer screening to other cancer tests. The bad news is that screening rates for lung cancer were almost 4X lower than for breast and colon cancer (17% vs. 65%) among 35.2k people eligible for both tests in 2022. But the fact that so many people eligible for lung screening got other cancer tests means they could be open to outreach efforts promoting lung screening.
- GE Finalizes Nihon Radiopharma Buy: GE HealthCare ramped up its radiopharmaceutical operations in Japan by taking over full ownership of Nihon Medi-Physics. GE previously owned 50% of NMP, and acquiring the remaining stake from Sumitomo Chemical will enable it to build on NMP’s expertise in developing SPECT and PET radiotracers. NMP generated revenues of about $183M in 2023.
- Irregular Brain Lesions Predict Cognitive Decline: Irregularly-shaped white matter hyperintensities on brain MRI scans predict five-year cognitive decline. WMH volume is known as a cognitive decline marker, but isn’t precise. Instead, researchers analyzed WMH shape in 2.5k people who got 1.5T MRI scans in an aging study in Iceland, finding that irregular lesion shapes were associated with lower scores on cognitive tests. Irregular shapes could be linked to underlying changes in brain tissue due to cerebral small vessel disease.
- Alzheimer’s AI Alliance: Improving care for Alzheimer’s disease patients is the focus of a partnership between ACR and icometrix. icometrix’s AI-based icobrain aria application for detecting amyloid-related imaging abnormalities will be offered at a discounted price to clinical sites collaborating in the ALZ-NET network, which is managed and operated by ACR. Participants can use icobrain aria for detecting, quantifying, and grading both ARIA-E and ARIA-H while also generating severity scores that can guide anti-amyloid treatments.
- Blast Exposure Changes Brains: In a new study in Radiology, functional MRI scans showed that military veterans exposed to multiple blast injuries had alterations in brain functional connectivity and cortical volume that correlated with neurobehavioral symptoms. In all, 212 special operations veterans got fMRI scans, and those with high exposure to explosives had functional connectivity differences in multiple brain regions as well as higher cortical volume. An fMRI-based model that classified participants into high- and low-exposure groups had 88% sensitivity and 67% specificity.
- United Imaging Debuts Angio System: United Imaging is entering interventional radiology by launching a new angiography system at this week’s SIR 2025. uAngio AVIVA is the company’s first ceiling-mounted interventional radiology system and has features for easier operation including an intelligent voice assistant that supports hands-free commands and operation. It also sports intelligent 3D vision that simplifies patient positioning by recognizing the patient, C-arm, and table position in real time. uAngio AVIVA is pending FDA 510(k) clearance.
- DBT for Architectural Distortions: Growing use of DBT for mammography screening has increased the detection of architectural distortions on breast images. Previously these were sent to biopsy and surgical excision, but imaging surveillance may be a better option. So says a new AJR paper that tracked 106 women with architectural distortions on DBT. There were no malignancies found in women with normal ultrasound scans and normal biopsy results, suggesting that surgical excision of these distortions can be avoided in favor of imaging surveillance.
- TeraRecon Expands 3DR Relationship: TeraRecon expanded its relationship with 3DR Labs, which is adopting TeraRecon’s new TRSubscription unified platform for advanced visualization tools, clinical applications, and cloud services. The partnership will enable 3DR to move its hospital clients to the cloud for data transmission and remote visualization. TeraRecon is also joining 3DR’s AI Labs platform for AI-based workflow integration.
- RamSoft Collab Targets Prior Auth: RamSoft is collaborating with Alpha Nodus to integrate its Gravity AI front-office platform into RamSoft’s PowerServer RIS. Gravity includes AI-powered tools like automated document processing, cost estimates, scheduling, and prior authorization management to automate and speed up radiology workflows and augment RIS and EMR functionality. The companies say Gravity can reduce prior authorization turnaround from hours or days to just minutes.
- AZmed Gets New Chest AI Clearances: AZmed received two new FDA clearances for its AZchest tool for AI-based analysis of chest X-rays. The clearances cover assisting radiologists when interpreting chest radiographs for lung nodules, as well as triage capabilities for pneumothorax and pleural effusion. AZmed has also adjusted its portfolio branding, elevating the “Rayvolve” brand to cover its entire product portfolio and renaming specific clinical applications as AZchest and AZtrauma, which was cleared for fracture detection in kids in 2024 and in adults in 2022.
- Merge Scores British Distribution: Merge by Merative has ramped up distribution of its VNA technology in Great Britain through a new relationship with medical equipment distributor HSL. HSL notes that Merge VNA meets the needs of NHS hospitals and private providers by giving them a vendor-neutral solution that integrates with existing imaging systems and can grow with increasing data volumes and user demands.
- ASRT Taps BeRad Winners: ASRT this week named the winners of its inaugural BeRad Professionalism Award to recognize healthcare organizations that support professionalism among radiologic technologists. The two BeRad winners are Children’s Hospital of Orange County in California and University of Texas Southwestern Medical Center.
- Thomas Tapped to Lead Mach7: Former Volpara Health Technologies CEO Teri Thomas was tapped as CEO of Mach7 Technologies, taking over from Mike Lampron, who is stepping down after serving in the role since 2019. Thomas was Volpara CEO for over four years and guided the business through its 2024 acquisition by Lunit.
- Akumin Taps New Leadership: Radiology services provider Akumin is bringing on board a new leadership team, naming Envision Healthcare veteran Henry Howe as CEO, succeeding Krishna Kumar. Akumin’s CFO Juan Perez is also stepping down. Akumin was taken private in 2024 by its largest creditor, private equity firm Stonepeak, after filing for Chapter 11.
- Larry Muroff Dies: One of the true giants of radiology education passed away last week: radiologist Larry Muroff, MD. Muroff was a professor of radiology at two Florida universities and authored more than 80 articles during his career, but was perhaps best known for founding Educational Symposia, one of the largest providers of radiology-dedicated destination and online CME courses. He was 82.
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A New Resource for AI of MRI
Gleamer is expanding into AI of MRI with its acquisition of innovative AI developers Pixyl and Caerus Medical. Learn how the company is creating the most comprehensive AI portfolio for medical imaging.
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A Step-by-Step Guide to InteleShare Viewer
How can Intelerad’s InteleShare Viewer help you handle the demands of enterprise healthcare with a diagnostic-quality viewer? Learn about some of the tools available to you in this self-guided demo.
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2 Questions about AI for Radiology Leaders
Are today’s radiology AI solutions solving the right problems? And are there other solutions available for AI of brain MRI? Read this article from SpinTech MRI to learn how its STAGE solution can optimize MRI utilization.
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- Patient-Centered Innovation with Photon-Counting CT: Siemens Healthineers is committed to transforming medical imaging with its NAEOTOM Alpha class, now featuring three photon-counting CT systems. Find out how they can enhance your diagnostic results.
- Presenting Unboxing AI: Check out CARPL’s video series, Unboxing AI, featuring experts discussing AI and its future in radiology. The next episode on April 3 features Imon Banerjee, PhD, of Mayo Clinic – reserve your seat today.
- AI-Automated Thoracic Measurements: AI-generated measurements from Us2.ai’s AI echo software had good agreement with expert cardiologists for detecting signs of aortic dilation in patients with aortic stenosis in a recent clinical study. Find out how well it worked on this page.
- Give Patients a Clear Path to Accessing Medical Data: Clearpath is a simple integration that empowers digital delivery of medical records and images. Request a demo today to find out how you can ditch the disc and give your patients and third parties instant access to digital data.
- What’s Next for AI for Cancer Detection? AI is transforming the fight against cancer by enabling faster and more accurate cancer detection. Read this article by DeepHealth’s Niccolo Stefani to learn how the company is pioneering new ways to advance cancer screening and broader imaging-based care.
- The Benefits of the Cloud for Enterprise Imaging: How are you preparing for the future of cloud-based enterprise imaging? In this downloadable e-book from Optum, learn about the benefits of cloud-based enterprise imaging and how to develop a strategy that works for you.
- Medical Imaging Data for Improved Research: The need for high-quality medical imaging data is crucial to drive advancements in diagnostics and treatment. Schedule a demo today to learn how Enlitic’s ENDEX for data standardization and ENCOG for data anonymization enable researchers to access superior data while optimizing resources.
- Improve Patient Satisfaction with Clearer Imaging Insights: When patients better understand their imaging results, they’re more engaged and confident in their care. PocketHealth’s Image Reader adds anatomical visualizations to imaging records, improving comprehension, strengthening provider-patient relationships, and driving higher satisfaction. Learn more here.
- Revolutionizing 3D Imaging: Learn how Visage Imaging is revolutionizing 3D imaging for radiology with its Visage Ease VP solution for the Apple Vision Pro headset in this video with Steve Deaton, director of customer experience.
- A New Cloud-Based Viewing Solution: Mach7 Technologies has achieved a major milestone with the release of its eUnity Enterprise Diagnostic Viewer with the Amazon Web Services (AWS) HealthImaging Cloud. Learn how this solution creates simplicity for users while enabling faster diagnoses and better patient outcomes.
- How to Standardize CT Images: The quality and appearance of CT scans can vary considerably. In this white paper from Riverain Technologies, find out how image normalization can standardize CT images, making them easier to analyze and interpret.
- Elevating Generative Reporting to the Web: Learn about the next leap in patient-focused diagnostic imaging with KailoFlow, the web-based evolution of Kailo Medical’s generative structured reporting platform that combines progress, innovation, and accessibility.
- 3 Ways AI Can Enhance Radiology Workflows: While disease detection was the initial driver for AI in radiology, the technology can also help improve workflows and reduce workloads for radiologists. Learn how AI can contribute in this article from Merge by Merative.
- Unprecedented Insights Made Possible with AI: With the largest normative dataset of whole-body imaging in the world, Prenuvo’s AI researchers partner with the best academic minds to understand – like never before – what “normal” aging means. Learn about their work today.
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- The Leader in Molecular Imaging: United Imaging’s uMI portfolio of solutions is designed to help you lead the way in molecular imaging. From digital PET/CT systems designed to stand the test of time to the cutting-edge uEXPLORER total-body PET scanner, discover the uMI difference today.
- Reach New Heights with Enterprise Imaging Cloud: Embrace the potential of AGFA HealthCare’s Enterprise Imaging Cloud, a fully managed Software-as-a-Service (SaaS) solution that will transform the handling, storage, and accessibility of medical imaging data. Learn how EI Cloud can help you today.
- Get Your Head Around AI for Neuroradiology: Check out the latest blog from Blackford on how advances in deep learning algorithms for neurology imaging are improving outcomes and easing the burden on radiologists.
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