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Rating CT Image Quality, Prostate MRI, and DEXA Use Drops
August 10, 2026
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Together with
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“These findings suggest that the 5-star method provides a simple and reliable way to translate subjective radiologist perception into structured, analyzable data suitable for large multicenter studies.”
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Rehani M et al, in a study on a five-star rating system for CT image quality.
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X-ray is radiology’s bread and butter modality, but over 130 years after its discovery, new innovations in radiography are still becoming available. One of them is slot-scanning X-ray, which is particularly useful for orthopedic applications like spine imaging. We discuss some of the latest developments in this edition of The Imaging Wire Show. Enjoy the interview! – Brian Casey, Managing Editor
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As radiology strives to reduce CT radiation dose, one of its challenges is maintaining image quality while keeping dose low. A new five-star system for rating images is described in a new paper in EJR and could offer a solution by establishing an easy-to-understand global metric.
The radiology community has been making progress in reducing CT radiation dose, but much work remains to be done.
- In particular, radiology professionals struggle between the desire for better-looking images – which usually result from higher radiation dose – with low-dose images that may be noisier but are good enough to make a diagnosis.
While there are lots of metrics for measuring radiation dose, image quality doesn’t have a widely recognized scale.
- So a team from the IAEA and MGH worked together to develop one, based on the widely recognized five-star paradigm for ranking consumer-facing businesses.
In an interesting wrinkle, the five-star system acknowledges the dose dilemma, essentially penalizing images in which too much radiation dose was used to produce an image that’s crisper than what’s needed for diagnosis.
- On the other hand, the system rewards images that might be noisy due to use of less radiation, but that are still diagnostic.
The system’s ratings are as follows…
- Five stars – Acceptable, despite high image noise associated with low-dose CT.
- Four stars – Acceptable for all parts within the region of interest.
- Three stars – Acceptable, despite unintended high noise and/or some artifacts.
- Two stars – Excellent quality with unjustifiably low image noise and no artifacts.
- One star – Non-diagnostic, due to excessive noise or artifacts, or poor contrast.
To test the rating scale, IAEA and MGH researchers performed a study at six hospitals across five European countries.
- CT scans of 2.7k adults were acquired, and three radiologists per hospital were trained in the five-star scale and scored the images to see how reader subjectivity affected the scoring.
The study found…
- Reader concordance was up to 93% at some sites, indicating little variability in scoring.
- Overall discordance was rare, at 1.6%.
- The two-star ratings (in which too much radiation was used) were associated with higher radiation dose in nearly all patient weight groups.
The Takeaway
The new study shows that a five-star system for rating CT image quality is feasible and can reveal cases of unnecessarily high radiation dose. The question is whether the system remains an interesting thought experiment, or if it becomes an integral part of radiology’s effort to better manage radiation.
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Technical Brilliance That’s a Generation Ahead
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3T Wide-Bore MRI Delivers Power with Purpose
Translate groundbreaking discoveries into patient care with SIGNA Bolt, GE HealthCare’s visionary 3T MRI scanner that empowers leading-edge research for real patient care.
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The Power of a Smooth Go-Live
Don’t gamble on your healthcare institution’s go-live: take control of your PACS migration with ENDEX from Enlitic. Discover how ENDEX uses AI to standardize, normalize, and cleanse your imaging metadata before migration.
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- U.S. Lags in MRI Use for Prostate Cancer: Other countries are incorporating MRI into prostate cancer patient work-up, so why hasn’t the U.S.? MRI scans are almost twice as sensitive as traditional systematic biopsies, which sample a dozen randomly-selected spots – and are often painful for patients. As prostate cancer continues to be consistently overdiagnosed and overtreated in the U.S., a new article takes a look at how MRI could improve things, and what may be behind the delays.
- Prostate AI Helps Novice Radiologists: Quibim’s QP-Prostate software improved the sensitivity of less-experienced radiologists interpreting prostate MRI scans in new research in EJR. In a small proof-of-concept study with 52 patients with clinically significant prostate cancer who got 3T MRI scans, QP-Prostate assistance improved sensitivity on a per-case basis for the least experienced of four readers (from 73% to 87%). On a per-lesion basis, AI assistance improved sensitivity for three of the four readers, and improved AUCs for all readers, with no statistically significant change in specificity.
- VA Has Better Lung Cancer Outcomes: Patients with lung cancer treated at VA hospitals have better clinical outcomes. In a new study in JNCI Cancer Spectrum of 1.5M lung cancer patients from 2007 to 2019, three-year overall survival was the same at the beginning of the study (24%), but by the end was 10 percentage points higher at the VA compared to outside the system (51% vs. 41%). The authors attributed the gains to the VA’s multidisciplinary treatment approach, but also noted its organized implementation of CT lung cancer screening.
- Medicare Cuts Lead to DEXA Disparities: Since Medicare reimbursement for in-office DEXA scans was halved in the late 2000s, use of the osteoporosis test has declined 35% among Medicare beneficiaries. Still, new data from the ACR’s Neiman HPI shows those numbers don’t tell the full story. The DEXA decline was largest among Hispanic people (67%) and those living in resource-deprived communities. Patients who had access to preventive care visits had a 10X higher chance of continuing DEXA testing, further spelling out the inequitable effects of reimbursement cuts.
- Data Descriptions Vary at Hospitals: U.S. healthcare organizations aren’t using consistent terms to describe radiology metadata, which could complicate data standardization efforts. That’s according to a new study by Medicom of 22.1k imaging searches across 124 provider organizations. Researchers found 145 different spellings for “two-view chest radiograph,” while “screening mammogram” had 392 distinct terms, and six routine radiology procedures had 1.3k different names. Such variation can complicate a radiologist’s routine, such as by making it harder to pull up prior exams.
- GE’s ABUS Additions: Remember Candelis’ new StreamVue viewer software? The company found a major partner for the solution through a new alliance with GE HealthCare, which will offer it as part of its automated breast ultrasound technology. This announcement came as GE also launched its new Invenia ABUS Prime platform, complete with AI-enabled tools to assess supplemental scan quality and speed. Women with dense breasts have >4X higher risk of developing breast cancer, and GE has just added two tools to ensure these women get comprehensive screening.
- Azra Added to Blackford Platform: Despite last year’s news of its pending spinoff from Bayer, AI platform company Blackford is still out getting things done. The company last week announced a partnership with oncology solutions developer Azra AI that connects each company’s technologies, with the goal of improving follow-up for patients with cancer. Bayer reportedly is still looking for a buyer for Blackford, but the company has continued operations and exhibited at the SIIM 2026 meeting in June.
- Lancet Imaging Journal Debuts: The Lancet this month published the first article in a new journal dedicated to medical imaging and theranostics. The Lancet Medical Imaging & Theranostics recognizes imaging’s crucial role in patient care, and the inaugural article describes a technique using low-dose CT to quantify tau accumulations as part of PET/CT scans, without the need for a separate MRI scan. Findings from the HEAD trial of 387 people showed that CT-derived standardized uptake value ratios had near-perfect agreement with MRI.
- Imaging Links Cardiac Function to Brain Atrophy: The link between cardiac function and brain health is underscored in a new research study. In the Vanderbilt Memory and Aging Project, 756 adults over age 50 got echocardiography exams to measure cardiac output as well as brain MRI scans of gray matter. Those who had a genetic propensity for Alzheimer’s disease and lower cardiac output on echo also had smaller brain volumes, indicating that subclinical cardiac dysfunction could be related to neurodegeneration in some at-risk individuals.
- Canada’s Pay-to-Play Imaging Policy: In Alberta, Canada, individuals can now pay for imaging at private clinics, with no referral required. While some believe the policy raises red flags about equitable access, new commentary from the Fraser Institute takes a different tack. The authors cite Canada’s median wait time of seven months for MRI scans, arguing that more money will incentivize investment in new machines and take some patients out of the government queue. They also swatted down concerns that the nation is moving toward a “U.S.-style” system of non-universal healthcare.
- Natoe AI Launches Telerad Service: Are you ready for AI-forward teleradiology? Florida startup Natoe AI has begun offering a teleradiology service in which FDA-cleared AI algorithms first review cases and produce structured pre-read draft reports that are then approved by board-certified radiologists before being delivered to referring physicians. Natoe’s platform integrates with existing PACS networks, and cases are assigned to radiologists based on subspecialty, imaging modality, and state licensure requirements.
- Siemens Scores Helium-Free MRI Clearances: Siemens Healthineers received FDA clearance for new offerings in its Magnetom Flow family of helium-free MRI scanners. The company launched the first Flow scanners in 2025 based on DryCool technology that requires only 0.7 liters of helium compared to 1k liters for conventional MRI systems. The newly cleared Magnetom Flow systems feature more powerful gradients and new software features.
- FDA Clears Esaote Intraoperative MRI: Esaote’s I-Genius intraoperative MRI scanner is among the radiology devices to recently secure FDA clearance. Esaote highlighted the 0.25T open MRI scanner at AANS 2026 in May, emphasizing the system’s specialized coils that enable patients to remain on the scanner table during surgeries. The design gives clinicians the benefit of intraoperative MRI guidance without disrupting workflow.
- Nanox Plans $8M Funding Round: X-ray developer Nanox may have found a way out of its cash crunch, last week announcing an agreement to sell $8M in shares to an institutional investor. The company in July included a warning in documents filed with the SEC about its ability to continue as a going concern in the wake of a $75M annual net loss. Nanox in April announced a restructuring designed to cut costs as it ramps up sales of its Nanox.ARC cold-cathode digital X-ray technology.
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MRI Solutions for Claustrophobic Patients
Neurological Associates of Long Island had an Alzheimer’s patient who was unable to tolerate MRI due to severe claustrophobia. Read how she completed the scan calmly and without movement thanks to Fujifilm’s Echelon Synergy 1.5T MRI system.
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Radiologists Can Tell
When technology interrupts workflow, it’s obvious. You deserve better. Learn how modern reporting built by and for radiologists works for you. See the difference.
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- From Image Exchange to Enterprise Interoperability: Easily share, access, and exchange any medical image with solutions from Medicom. Deliver critical studies directly into the EHR to ease clinician burden, simplify your tech stack, and unlock the research potential hidden in clinical imaging data.
- Operating Differently in Radiology: Every year spent relying on fragmented workflows makes it harder to improve throughput, retain radiologists, and prepare for future growth. Discover why leading radiology groups are adopting operational transformation platforms to create faster, fairer, and less fatiguing radiology practices.
- AI-Assisted Radiology Reporting: Move beyond legacy radiology reporting with AI-assisted reporting from Mosaic Technologies. See how Mosaic Reporting can help your organization move faster today while building for tomorrow.
- How AI Powers Lung Cancer Screening: Discover how DeepHealth’s AI and workflow applications are helping radiologists report findings efficiently and with consistency in the U.K. national lung cancer screening program, finding cancers earlier at more treatable stages.
- A Next-Generation Oncology Ecosystem: Quibim has launched their next-generation oncology ecosystem platform. Find out how QP-Prostate provides a comprehensive, end-to-end management workflow for prostate cancer care, supporting clinicians from the earliest stages of image acquisition through diagnosis, patient management, and follow-up.
- The Path to Digital Pathology: Hospital for Special Surgery in New York City had a vision: digital pathology coupled with fully integrated radiology, all in one enterprise imaging system. Learn how they turned this vision into reality on this page from Sectra.
- Lower Doses, Higher Quality: What if you could reduce radiation exposure without compromising accuracy in MSK imaging? Discover a system from Siemens Healthineers that supports dose-saving strategies while delivering high-quality images for confident diagnoses and maintaining clinical accuracy.
- Excellent Workflow and Quality Images: HCA Healthcare – the largest health system in the U.S. – named Philips its sole-source supplier for diagnostic X-ray under a five-year agreement. Learn more about the workflow and image quality behind this new alliance.
- IT Solutions for Radiologist Efficiency: Inefficiencies in reporting are some of the biggest challenges facing radiologists today. Learn how imaging IT solutions from Altamont Software can help radiologists work more efficiently in this Imaging Wire Show video.
- Advancing Enterprise Imaging With IntelePACS: Attend this Lunch & Learn session from Intelerad on Tuesday, August 11, from 2 p.m. to 3 p.m. EDT to learn how IntelePACS helps radiology groups, hospitals, and health systems simplify imaging workflows through a scalable, enterprise-ready platform.
- Would You Trust a Chatbot to Educate Your Patients? Scanslated provides patient education powered by real human intelligence – not AI. Scanslated’s interactive reports use unique, patient-centered explanations written by board-certified physicians specifically for a patient audience. Learn how Scanslated can benefit your patients today.
- Building a Life and Career in Radiology: What does it take to build a meaningful career in radiology? Erin Gomez, MD, talks about her unconventional path into medicine in the latest episode of Medality’s The Joys of Radiology with host Gautam Agarwal, MD.
- Advanced Medical Imaging in Small-Town Iowa: Clarinda Regional Health Center has been a cornerstone of care in Clarinda, Iowa, since opening its doors in 1939. Learn how CRHC partnered with United Imaging to bring advanced imaging capabilities directly to its patients.
- Connected Imaging. Empowered Flow: Know those rare and indescribable moments at work when distractions melt away? AGFA HealthCare’s Enterprise Imaging Platform is designed to keep you in that hyper-focused state of mind all day long. Learn more about their solutions today.
- Fewer Biopsies, Better Accuracy: AI is converging with TI-RADS and BI-RADS in ways that go beyond automation. Read this article from Kailo Medical to learn how structured reporting is reducing unnecessary biopsies, improving consistency, and reclaiming clinical time.
- Driving Efficiency in Radiology: Radiology’s workforce is under pressure. Discover evidence-based strategies for driving efficiency without burning out your staff in this e-book from Riverain Technologies.
- Address Your Imaging Needs Today: Face the future with confidence with enterprise imaging solutions from Merge. Read this article to learn more about how their technologies will help you meet your needs today and set you up for success tomorrow.
- The Economics of AI-Assisted Heart Failure Diagnosis: An AI-assisted diagnostic pathway for diagnosing heart failure saved $1.4k per patient – without compromising diagnostic accuracy. Read the white paper from Us2.ai.
- Rapid AI Deployment in Emergency Care: University Hospitals used CARPL to deploy AZmed’s fracture detection tool directly in the emergency department, reducing interpretation time by 30% without disrupting workflows. Learn how UH accelerated AI deployment.
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