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Radiology’s Rising Workload, Moral Distress, and Trade Wars
April 10, 2025
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Together with
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“Understaffed regulatory agencies (i.e., FDA) will tend to say ‘no’ much more often if they do not have the staff, time, or focus needed to reach a nuanced ‘yes.’ Think of the breakthroughs at FDA; think about how much extra time and staff those have required.”
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Regulatory consultant Steven Grossman of HPS Group on recent FDA staffing cuts.
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If you think new imaging IT technologies will reduce radiologist workload in the future, you might want to think again. Researchers who analyzed hundreds of studies on new scientific advances predicted that nearly half of them would increase radiologists’ workload – especially AI.
Radiologists are desperately in need of help to manage rising imaging volumes during a period of global workforce shortages.
But how true is that belief? In the new study in European Journal of Radiology, radiologists Thomas Kwee, MD, and Robert Kwee, MD, from the Netherlands analyzed a random sample of 416 articles published in 2024 on imaging applications that could affect future radiologist workloads, finding …
- 49% of the articles on applications that had the potential to directly impact patient care would increase radiologist workload in the tertiary care academic setting.
- Studies on AI-focused applications were 14X more likely to increase workload compared to research that didn’t.
- Similar numbers were found for non-academic general teaching hospitals.
- The findings are largely similar to a 2019 study by Kwee et al that used the same methodology.
Why don’t new imaging applications show more potential to reduce radiologists’ workloads?
- The Kwees found that image post-processing and interpretation times have grown for both existing and new applications.
In the specific case of AI, they cited an example in which a deep learning algorithm was introduced to analyze CT scans to segment and classify features of spontaneous intracerebral hemorrhage and predict hematoma expansion.
- The model successfully predicted hematoma expansion and automatically segmented lesions, but CT images still had to be post-processed with a separate workflow. This required additional radiologist interpretation time and extended their workload.
The Takeaway
The new study throws cold water on the idea that AI will be able to solve radiology’s workload dilemma. It’s possible that AI will have an impact on radiology that’s similar to that of PACS in the 1990s in making radiologists more productive, but we’ll need new efficiency-oriented changes to achieve that goal.
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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.
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Give Your Patients the Experience They Want
Empower patients to take control of their healthcare journey by giving them mobile access to their records and images with Clearpath, the world’s first digital fulfillment platform for records and films. Book a demo today.
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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 10 features Mads Jarner Brevadt of Radiobotics – reserve your seat today.
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- What Causes Moral Distress in Radiology? A survey of academic radiologists revealed reasons for moral distress, a known contributor to burnout and job turnover. In a new paper in JACR, researchers analyzed 126 questionnaire responses from five institutions, finding four common reasons for moral distress: 1. Pressure to perform an unsafe number of studies; 2. High workload impeding resident education; 2. Lack of administrative support for patient care; and 4. Pressure to conduct unnecessary imaging.
- DBT Changes Breast Cancer Workup: There have been subtle changes in the workup of patients with abnormal mammograms following the shift to DBT imaging. In a new paper in JACR, researchers reviewed 274.7k mammograms acquired from 2011-2020, finding that follow-up ultrasound was used over 4X more often with DBT than conventional digital mammography (21% vs. 4.7%). DBT biopsy rates were slightly higher (16% vs. 14%), but invasive surgical biopsies were less common with DBT than DM (3.2% vs. 5.8%).
- AI for Mastectomy Follow-Up: AI could be a good surveillance tool for detecting contralateral breast cancer in women who have been treated with unilateral mastectomy. Researchers in a paper in Radiology used Lunit’s Insight MMG to track 4.2k women who got mastectomies, finding that standalone AI had a higher cancer detection rate per 1k exams (17 vs. 15) and sensitivity (66% vs. 55%) but lower specificity (92% vs. 98%). Standalone AI also detected 16 of 50 cancers that radiologists missed.
- CPT Codes for AI Cardiac Analysis: The AMA approved new Category III CPT codes for AI-assisted perivascular fat analysis from cardiac CT scans using software like Caristo Diagnostics’ CaRi-Heart solution. Such algorithms detect signs of coronary inflammation that can destabilize plaque and trigger cardiac events, enabling proactive, AI-based heart disease risk assessments. Code X409T and add-on code X434T will be published in July and will be effective in January 2026. Caristo’s CaRi-Plaque algorithm was cleared earlier this year.
- HeartFlow AI Reduces Cardiac Testing: Implementation of HeartFlow’s FFR-CT AI software in the U.K. reduced follow-up testing without a statistically significant difference in clinical outcomes. In a new paper in Nature Medicine, researchers compared FFR-CT to conventional CCTA for working up 98.4k patients with suspected coronary artery disease at 27 hospitals. FFR-CT reduced the rate of invasive coronary angiography (14.9% vs. 16%) and of noninvasive cardiac tests (17% vs. 19%) without differences in all-cause or cardiovascular mortality.
- New Echo Contrast Moves Ahead: Ultrasound contrast developer Agitated Solutions is set to start a phase 3 clinical study of its ASI-02 echo microbubble agent after getting FDA clearance for an Investigational New Drug application.The trial will assess ASI-02’s safety and efficacy in up to 300 patients in the U.S. and Canada getting transthoracic echo exams. Unlike other echo agents, ASI-02 is designed for right heart exams and can be administered by a single sonographer, improving practice efficiency.
- Missed Cancer Appointments: Patients who have health-related social needs like financial hardship, transportation difficulties, and housing issues are more likely to miss cancer imaging appointments. Writing in a new study in JACR, researchers analyzed surveys from 2.9k imaging encounters, of which 23% involved cancer patients with unmet social needs. These patients were 29% more likely to miss imaging appointments. These patients could be identified with pre-appointment screening, but only 17% said they got screened before their exams.
- Medivis Gets Spine Navigation Nod: Medivis received FDA 510(k) clearance for its Spine Navigation platform, which uses AI and augmented reality to provide holographic surgical navigation during open and minimally invasive spine procedures. Medivis sees the platform’s main applications in orthopedic and neurosurgery, and is highlighting its computer vision algorithms, AI segmentation, and lightweight hardware that gives surgeons ergonomic freedom. Medivis raised $20M in 2023.
- Proprio Gets New Paradigm Guidance: Proprio received the second FDA clearance for its Paradigm AI-based 3D surgical guidance platform, adding to the original 510(k) in 2023. The new clearance covers intraoperative measurements that can be made in real time on Paradigm during surgeries, enabling surgeons to work more efficiently without having to rely on pre- or post-operative measurements. Proprio raised $23M in 2020.
- Siemens Signs Singapore General Hospital: Siemens Healthineers signed a memorandum of understanding with Singapore General Hospital to set up a five-year partnership covering new medical technology and patient care initiatives, including AI-driven diagnostics, digital health solutions, and sustainability initiatives. The agreement will extend their existing relationship in diagnostic imaging.
- China Probes X-Ray Tubes: Medical imaging has been drawn into the spiraling trade war between the U.S. and China. China’s Ministry of Commerce last week announced it was launching a dumping probe of CT X-ray tubes made in the U.S. and India. Chinese tube makers complained that imports of U.S. and Indian CT tubes grew 13% even as prices continued to decline, producing losses for local firms. The ministry also launched a separate probe into imported CT tubes, which allegedly have harmed local Chinese manufacturers.
- More Worries about Trade Wars: The trade war’s impact on medical practices has at least one industry group worried. MGMA noted that physician practices rely on a global supply chain, but have limited ability to pass on higher costs due to fixed reimbursement rates. This may force medical practices to absorb increased costs, which could impact patient care and may make it harder for groups to stay in operation.
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Transforming Stroke Care with Mobile Stroke Units
When it comes to stroke, time is brain. And many providers are turning to CT-equipped mobile stroke units to slash the time from symptom onset to diagnosis and treatment. Learn more on this page from Siemens Healthineers.
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Patient Attitudes Towards AI-Echo
The medical imaging field is rapidly accepting AI, but how are patients feeling about the shift? Get the scoop on patients’ positive opinions toward Us2.ai’s software that supports task-shifting from conventional echo to AI-echo.
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The Future of SmartTechnology
SmartTechnology is DeepHealth’s solution for bringing informatics and imaging systems closer together by embedding informatics into hardware, creating completely new workflows. Learn how it works in this interview with CTO Sham Sokka.
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- AI Tools for Lung Cancer Screening: CT lung cancer screening is gaining momentum around the world. Learn about AI-based nodule detection tools that can improve the accuracy of low-dose CT scans in this video from Riverain Technologies.
- Radiology Practice Models Explained: Radiologist Kurt Schoppe, MD, isn’t afraid to speak his mind, so listen to this episode of Medality’s Radiology Report Podcast to hear his take on healthcare policy and economics.
- Integrating AI into Clinical Practice: AI has the potential to revolutionize healthcare, but it requires a collaborative effort between clinicians and AI experts. In this micro-learning course from Calantic by Bayer, learn about the latest developments in healthcare AI.
- 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.
- AI Enables Automated Cobb Angle Measurements: Gleamer’s BoneMetrics AI solution accurately predicted the Cobb angle of scoliosis patients with high accuracy compared to manual measurements made by clinicians. Learn more in this paper.
- Helping Providers Deliver Critical Answers to Patients: Intelerad’s new InteleGence solution helps providers deliver critical answers to patients when they need them most by deploying AI tools to simplify workflows and assist in precision diagnostics. Learn more about how InteleGence works today.
- Start at the Source to Improve MRI: Looking for ways to improve MRI speed and image quality while addressing broader concerns in healthcare? The answer may lie in proven MRI physics in your existing scanner – learn how to unlock it with STAGE from SpinTech MRI.
- Powering Reporting Progress with Efficiency: Radiologists are looking to maximize their efficiency with new reporting tools that integrate easily with their PACS and RIS. Learn more about solutions from Kailo Medical in this Imaging Wire Show interview with Jason Mercieca and Dieter Smith.
- Perspectives on Cybersecurity in Medical Imaging: Healthcare organizations are a prime target for cyberattacks, so how can you proactively defend yourself against these threats? Learn how to protect your operations – and your patients – by watching this on-demand webinar 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.
- Unlock Next-Generation AI with Foundation Models: Learn about Microsoft’s new family of cutting-edge multimodal medical imaging foundation models designed for healthcare organizations to test, fine-tune, and build tailored AI solutions specific to their needs, while minimizing extensive compute and data requirements.
- Next-Generation Enterprise Imaging: U.S. healthcare organizations are making a definitive pivot to cloud technology. In this white paper from AGFA HealthCare and HIMSS, learn about the benefits of cloud-based enterprise imaging. Download the white paper today.
- Celebrating Happy Customers: There’s nothing better than happy customers. Find out what radiology personnel at Western New York MRI in Buffalo had to say about their new uMR 680 scanner from United Imaging.
- Missed Appointments and Cancellations Can Add Up: Every missed appointment can cost providers an average of $200. PocketHealth Appointment Reminders can decrease no-show rates by up to 30%. Find out how in this article.
- Visage’s Top 5 Topics from RSNA 2024: What were the hot topics from RSNA 2024? From a big increase in booth traffic to immersive excitement over the Visage Ease VP spatial computing app, RSNA attendees got a close look at everything Visage Imaging has to offer in cloud-based PACS.
- AI and Neuroradiology Workflow: How can AI add value to workflows in neuroradiology? Watch this on-demand video to learn from Blackford partners how AI can help, from assisting providers in managing acute stroke patients to the impact of CPT III codes in driving adoption of brain volumetric AI solutions.
- The Invisible Edge of Data Migration: AI-enabled data migration has several advantages for healthcare organizations, from efficiency that’s 5-10X faster than traditional methods to success rates as high as 99%. Learn more on this page from Enlitic.
- Experience the Power of Workflow Orchestration: Mach7’s UnityVue Workflow Orchestration Platform is a groundbreaking new solution that creates a unified view of patient imaging data, speeding patient care delivery, creating more efficient workflows, and reducing radiologist stress. Experience the power of UnityVue for yourself.
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