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Doctors Adopt ‘Shadow AI,’ DOE Deletes ALARA, and Patient Views of AI
January 26, 2026
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Together with
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“Radiology is often described as the art of making the invisible visible. But that is only partly true. What images really do is something else: They force us to decide what matters.”
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Mathias Goyen, MD, chief medical officer Europe for GE HealthCare.
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Doctors under pressure to work more efficiently are looking for help from “shadow AI” – artificial intelligence applications adopted outside a formal hospital approval process. A new survey of U.S. healthcare personnel found that many administrators have encountered unauthorized AI tools in their organizations, including some used for direct patient care.
U.S. healthcare providers are struggling under rising patient volumes in the midst of an ongoing workforce shortage, a situation that’s leading to burnout among clinicians.
- AI is often touted as a possible solution by enabling providers to do more with less, but the jury is still out on whether this works in the real world.
The new survey was conducted by Wolters Kluwer Health to assess usage of what the report described as “shadow AI,” or AI that’s adopted without proper hospital authorization processes.
- Shadow AI introduces risk to data, security, and privacy, and providers should better understand the need for an enterprise approach to AI with appropriate controls.
It’s worth noting that the report’s use of the term “authorization” applies primarily to an institution’s internal approval and governance processes for AI rather than formal FDA regulatory authorization.
- AI algorithms that aren’t used for direct patient care don’t require FDA authorization, as the agency pointed out in a guidance just a few weeks ago.
Researchers surveyed 518 health professionals, finding…
- 41% were aware of colleagues using unauthorized AI tools.
- 17% said they had personally used an unauthorized tool.
- 10% said they had used an unauthorized AI tool for direct patient care.
While the report’s recommendation for stronger AI governance is valid, there could be a competitive subtext to the findings. Wolters Kluwer offers healthcare clinical decision support solutions, and the company is currently locked in a fierce battle with OpenEvidence for dominance in the CDS space.
- OpenEvidence’s CDS solution is wildly popular with clinicians, many of whom install and consult with the software on their own, outside an enterprise-level governance – exactly the kind of “unauthorized” model the new report criticizes.
The Takeaway
The Wolters Kluwer report could be shedding light on a concerning new trend, or it could represent an effort by an established player to shut out a competitive threat. Either way, its warning on the need for appropriate enterprise-level AI governance should not be ignored.
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Every Image Tells a Story
Intelerad’s enterprise image management solutions are empowering radiologists and patients while transforming radiology workflows. Learn about the technologies they highlighted at RSNA 2025 for empowering imaging professionals.
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Will Radiologists Lead or Be Led?
Radiology is facing a defining moment. In this episode of The Radiology Report, host Daniel Arnold of Medality sat down with Frank Lexa, MD, to talk candidly about what comes next for the specialty.
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- DOE Deletes ALARA Principle: The U.S. Department of Energy is ending the use of the “as low as reasonably achievable” guideline for regulating radiation safety in humans. The ALARA principle assumes radiation dose carries risk even at low levels, but extremely low doses are acceptable in some cases if minimized. The DOE’s move only applies to nuclear power workplace regulation, but the ALARA concept is used in healthcare to guide protocols for modalities that use radiation, like CT.
- Patients Support AI for Mammography: In a study that’s good news for companies providing add-on AI interpretation services to patients, researchers in Breast Cancer Research and Treatment surveyed 924 people to find that 72% supported the use of AI for mammograms, although only 6.6% liked the idea of AI as a sole reader. Patients at safety-net hospitals were less likely to support AI than those at academic centers (OR = 0.71) but were more likely to request AI review if a radiologist found an abnormality (OR = 1.83).
- More Support for Mammography AI: A second study – this one in European Radiology – showed similar levels of support for breast imaging AI among patients surveyed in Ireland. Researchers queried 1.5k patients in their breast clinic, finding 46% agreed with the use of medical AI while 44% were indifferent. In all, 61% agreed to having their mammograms read by AI and a radiologist, while 67% didn’t want AI to be the sole reader. Even if AI was shown to be more accurate, 66% still wanted radiologists reviewing their mammograms.
- Cancer Mortality Drops in Young People: Despite a highly publicized rise in cancer incidence among younger people, a new JAMA research letter shows that U.S. cancer mortality fell from 1990 to 2023 among 1.3M people younger than 50 who died of cancer. In these people, the death rate per 100k cases fell 44% (26 to 14 deaths), while annual deaths from 2014 to 2023 fell for breast cancer (-1.4%), lung cancer (-5.7%), brain cancer (-0.3%), and leukemia (-2.3%). The only cancer where deaths rose was colorectal cancer (+1.1%).
- Qure Lands Grant for POCUS AI: Qure.ai landed a multimillion-dollar grant from the Gates Foundation to develop AI for point-of-care ultrasound to detect tuberculosis and pneumonia. The company has been active in applying its X-ray and CT algorithms to detect lung disease in developing countries, and the grant will help it expand into POCUS, which is popular worldwide thanks to its low cost and portability. Qure will also develop an open-source multimodality database to house medical images and other clinical information.
- Intermountain Finalizes Steinberg Acquisition: Utah-based health system Intermountain Health completed its acquisition of Steinberg Diagnostic Medical Imaging, which operates 12 imaging centers in the Las Vegas area. The purchase boosts Intermountain’s presence in southern Nevada and reflects the ongoing consolidation of independent imaging services providers in the U.S.
- Enlarged Spleen Linked to Cancer Risk: People with splenomegaly – an abnormally enlarged spleen – are at greater risk for hematologic cancer or liver disease. In a study in JAMA Oncology, researchers used MRI or CT to calculate spleen size and volume in 47.1k people from the general population. Over a five-year follow-up period, those above the 99th percentile for either spleen length or volume were at 5X and 11X higher risk of hematologic cancer, respectively, with similar numbers for liver disease. Imaging could help detect disease incidentally.
- MedPAC Asks for 2027 Medicare Bump: The Medicare Payment Advisory Commission plans to advise Congress to raise 2027 Medicare payment rates by 0.5 percentage points above current law in its upcoming report. That’s the good news. The bad news is, such an increase would boost Medicare spending by $750M to $2B in one year, and because Medicare has a fixed budget, increases in one area have to be offset by cuts in another. Stay tuned.
- Study Probes Ultrasound/Photoacoustic Combo: Researchers have acquired the first human images with a new imaging technology that combines ultrasound with photoacoustic imaging. The system integrates rotational ultrasound tomography with photoacoustic tomography, and researchers described a proof-of-concept study with RUS-PAT in Nature Biomedical Engineering where they acquired images of multiple body regions. They believe RUS-PAT could be used to acquire images of both tissue and blood vessels at a lower cost than conventional modalities like CT and MRI.
- Ultrasound/Optical Imaging Reduces Biopsies: Another hybrid ultrasound technology – this one ultrasound-guided diffuse optical tomography – was found to reduce unnecessary breast biopsies. US-DOT provides hemoglobin concentration maps and blood oxygen saturation levels that can indicate higher tumor metabolism, with total hemoglobin concentration higher and blood oxygen saturation lower in malignant lesions. In a study in Breast Cancer Research on 226 patients US-DOT reduced unnecessary biopsies by 25% with a false-negative rate of only 1.8%.
- Imricor’s First FDA Clearance: Imricor Medical Systems received FDA 510(k) clearance for its Vision-MR Diagnostic Catheter, marking the company’s first U.S. regulatory clearance. The MRI-compatible catheter is designed for real-time use and is a key component of Imricor’s broader MRI-guided electrophysiology platform. The clearance enables U.S. commercialization and should be the first of multiple regulatory milestones as the company rolls out its full MRI-guided EP suite.
- Startup Pursues Canine Cancer Detection: It’s not imaging, but it’s fascinating nonetheless: a New Jersey startup called SpotitEarly is developing a method that combines AI with trained dogs that detect cancer based on odor signatures in breath samples. SpotitEarly last week announced a relationship with Fox Chase Cancer Center to investigate the company’s LUCID test for patients being evaluated for suspected lung cancer. The test uses sensors to monitor canine behavior and physiological signals, and translate them to a standardized approach to cancer detection.
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Radiology Case Report
A man in his 50s presented with syncope with minor head trauma and unassociated risk factors. Find out how MRI helped provide a diagnosis in this case study.
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Ensuring the Safety and Well-Being of Patients Undergoing MR
It’s important to create a safe environment for every patient, every scan. Unlock how thoughtful planning and innovative technology from Philips can reduce risks and enhance care during MRI procedures.
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It’s Time to Make AI Adoption Simple
Gleamer unifies a fragmented AI landscape into a single, simple, powerful platform with GleamerOS. Discover an AI ecosystem where everything is designed to be intuitive, consistent, and scalable, making AI adoption simpler than ever.
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- Transform Imaging Data into Actionable Predictions: When you choose Quibim, you get more than a partner for detecting and diagnosing prostate cancer on MRI scans. Learn how they can help you transform imaging data into actionable predictions by booking a demo today.
- Transform Your Workflow with Intelligent Imaging: Radiology departments face growing challenges: higher workloads, fewer staff, and tighter budgets. Discover how intelligent imaging technology from Siemens Healthineers streamlines processes, reduces stress, and improves outcomes. Access the white paper now and transform your workflow.
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- Empowering Radiologists at the Point of Interpretation: Reserve your seat at this February 12 webinar to learn how Rad AI and RSNA Ventures have partnered to deliver trusted, peer-reviewed RSNA insights directly into the radiologist’s workflow — at the exact point of interpretation.
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- Optimize Radiology Workflows: Harness cloud and AI technology to help your radiology teams unlock insights, increase efficiencies, and improve patient care. Learn more about an integrated approach to AI in radiology in this e-book from Microsoft.
- Digital Radiography Designed for Freedom: United Imaging’s new uDR Aurora CX digital radiography system was designed to give you unprecedented freedom in imaging patients thanks to its new advances in computer vision, automation, and AI diagnostics.
- Redefining Breast Imaging in the Enterprise Era: As breast imaging grows more complex, radiology teams need more than siloed tools. Watch this on-demand webinar hosted by AGFA HealthCare about transforming breast imaging workflows in the enterprise imaging era.
- Workflow Orchestration to Revolutionize Imaging: Intelligent teleradiology solutions can combat radiologist shortages with smarter workflows that reduce burnout and improve patient care. Find out how workflow orchestration solutions from Merge are making it possible.
- Elevating Breast Cancer Detection: Breast Suite from DeepHealth is a new package of AI-powered solutions delivering increased breast cancer detection rates, risk stratification tools, and viewing and reporting workflow acceleration. Find out how it can benefit your practice today.
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