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While recently published research raised concerns about projections of future radiation-induced cancers from computed tomography (CT) scans, Joseph Cavallo, M.D., maintained in a new 

 that advances in technology may continue to facilitate lower radiation dosing with CT.

“Whether it's the photon-counting CT machines or AI post-processing algorithms, there are multiple avenues to lower dosing … It's not going to be a one size fits all, or a silver bullet. It's going to be a combination of different technologies on the machine side, on the software side, that help us continually make these examinations safer and improve the risk benefit profile moving forward,” noted Dr. Cavallo, an assistant professor of radiology and biomedical imaging at Yale School of Medicine in New Haven, Ct.

Highlighting significant reductions with cardiac CT radiation dosing in recent years, Mahadevappa Mahesh, MS, Ph.D., also challenged perceptions about overuse of CT scans in the emergency room setting.

“Generally, emergency room physicians get the bad rap (with the perception that) they're ordering too many studies. … If we look (at this) closely, emergency room physicians, radiology, everybody (is) working with such a time-compressed timeline, and they're trying to save the patient. … As a medical physicist, I am all for radiation dose reduction, but at the same time, I am also a proponent of never tying anybody's hand because of radiation, even in the cath lab. If you have to do the procedure, do it,” asserted Dr. Mahesh. the president of the American Association of Physicists in Medicine (AAPM), and a professor of radiology and radiological sciences at the Johns Hopkins School of Medicine.

(Editor’s note: For related content, see “

The Reading Room Podcast: Current Insights on Recent Research About Radiation-Induced Cancers with CT Scans, Part 1

What New Research Reveals About Computed Tomography and Radiation-Induced Cancer Risk

Nine Takeaways from New Research on CT Scans and Radiation-Induced Cancers

For more insights from Dr. Cavallo and Dr. Mahesh, listen below or 

In a second part of a new podcast episode on recently published research on projected radiation-induced cancers from computed tomography (CT) scans, Mahadevappa Mahesh, MS, Ph.D., and Joseph Cavallo, M.D., offer current perspectives on cardiac CT dosing, AI advances and the importance of teamwork in ensuring appropriate dosing for CT. 

The Reading Room Podcast: Current Insights on Recent Research About Radiation-Induced Cancers with CT Scans, Part 2

In a recently published study, researchers estimated that out of an estimated 93 million computed tomography (CT) exams performed in 2023, there may be 103,000 future cases of radiation-induced cancers. Based on current CT use and radiation dosing levels, the study authors suggested that radiation-induced cancers from CT exposure may account for 5 percent of all cancer cases.

, Joseph Cavallo, M.D., emphasized appropriate perspective with the aforementioned risk modeling study and taking all the risks into account to optimize patient care.

“I would have liked to see a little more discussion about underlying risk in general. They speak to the risk of CT, but we're really not comparing the risk of a CT versus the risk of doing nothing … Hopefully, in all the cases where we're doing CT or other radiation-based imaging, we should be comparing the risk of CT versus the risk of the underlying disease and the risk of complications from the underlying disease, and ultimately, the risk of missing the diagnosis of some of those diseases,” posited Dr. Cavallo, an assistant professor of radiology and biomedical imaging at Yale School of Medicine in New Haven, Ct.

 suggested that multiphase scanning, occurring in 28.5 percent of CT exams, is commonly overutilized, Mahadevappa Mahesh, MS, Ph.D., emphasized that patient history and disease presentation are key considerations.

“Which patients (had the multiphase scanning)? Was it necessary? Because it's very subjective to say overused. … Did any of them have cancer-related studies? Do they have other underlying diseases? (In these cases), you only (get) answers with a triphasic study. That's important to say. I'm not refuting the numbers, but the justification of these numbers is very important,” added Dr. Mahesh, the president of the American Association of Physicists in Medicine (AAPM), and a professor of radiology and radiological sciences at the Johns Hopkins School of Medicine.

AI Denoising Bolsters Ultra-Low-Dose CT Detection of Pneumonia Findings in Immunocompromised Adults

For more insights from Dr. Cavallo and Dr. Mahesh, listen below or 

In a new podcast, Mahadevappa Mahesh, MS, Ph.D., and Joseph Cavallo, M.D., share their perspectives on recently published research looking at projections for future radiation-induced cancers from computed tomography (CT) scans.

Use of the AI-powered Salix Coronary Plaque module, which offers detection of high-risk plaque within 10 minutes based off of CCTA scans, will reportedly qualify for $950 in Category 1 CPT reimbursement in 2026.



FDA Clears Coronary Plaque Software Module for Coronary CT Angiography

In addition to facilitating centralized scanning for a variety of imaging, the TechLive system may help ease the strain of technologist shortages and broaden access to advanced imaging exams.

FDA Clears Remote Scanning Platform TechLive for MRI, CT, PET/CT and Ultrasound

In a prospective study involving nearly 100 patients with Long Covid, 57 percent of patients had PET/MRI abnormalities and 90 percent of the cohort had abnormalities on dual-energy CT scans.

Study Reveals Significant Prevalence of Abnormal PET/MRI and Dual-Energy CT Findings with Long Covid 

The dose length product (DLP) for the flash mode on a dual-source photon-counting CT system was less than a third of that for the spiral mode, according to a study of CTA findings for 1,000 patients presented at the Society of Cardiovascular Computed Tomography (SCCT) conference. 

Photon-Counting CT Study Examines Impact of Scan Mode on Radiation Dosing for CCTA in Patients with Non-Acute Chest Pain

For patients who had coronary CTA for acute chest pain, emerging research found no significant association between plaque burden grades with CAD-RADS 2.0 and cardiac events.

CCTA Study: Plaque Burden Offers No Prognostic Benefit for Predicting Cardiac Events in Patients with Acute Chest Pain

Conventional assessments for possible coronary artery disease based on presenting symptoms and/or risk profiles are inadequate, according to Amir Ahmadi, M.D.

In a recent interview, Dr. Ahmadi noted key research findings —presented at the European Congress of Cardiology in 2024 and currently being evaluated for a peer-reviewed publication — that showed that 67 percent of patients under 65 with a first heart attack had no pain two days prior, 54 percent had no pain until the day of the heart attack, and 47 percent of patients wouldn’t have met criteria for statin initiation two days prior to a heart attack.

“Coronary disease is a plaque in the heart. … We do everything about risk stratification by measuring the LDL (low-density lipoprotein) in the bloodstream, not the heart vessels. Now plaque quantification and looking at a CT can actually tell us … about the quantification of what actually matters at the level of the heart vessel, and that's game changing in my opinion,” emphasized Dr. Ahmadi, an associate professor of medicine and cardiology, and director of inpatient cardiology at the Mount Sinai Fuster Heart Hospital in New York City.

Dr. Ahmadi said use of the AI-powered software PlaqueIQ (Elucid) with computed tomography angiography (CTA) facilitates a shift from “risk factor guesstimation to treating the disease itself.” Not only does PlaqueIQ bolster accuracy with initial assessments, it enables monitoring of treatment as well, according to Dr. Ahmadi, who will be presenting on CT-guided treatment of CAD at the Society of Cardiovascular Computed Tomography (SCCT) conference in Montreal, Canada.

“What you need is an accurate, objective and reproducible measurement of different types of plaque, and specifically the types of plaque that are known to make the person and the lesion more prone to have a plaque rupture and heart attack,” maintained Dr. Ahmadi, the lead scientific advisor for Elucid.

Can Emerging AI Software Offer Detection of CAD on CCTA on Par with Radiologists?

Study Shows Enhanced Diagnosis of Coronary Artery Stenosis with Photon-Counting CTA

Meta-Analysis Shows Merits of AI with CTA Detection of Coronary Artery Stenosis and Calcified Plaque

For more insights from Dr. Ahmadi, watch the video below.

In a recent interview, Amir Ahmadi, M.D., discussed limitations of conventional diagnostic assessments for people with suspected coronary artery disease, and the emergence of AI-enabled plaque quantification to facilitate more timely detection and intervention.

Emerging Concepts in CT-Guided Treatment of Coronary Artery Disease

Emphasizing the preventative benefit of computed tomography angiography (CTA), C. Alberto Morales, M.D., discussed a friend whose father had a heart attack in his mid-30s. Given the family history, the friend had annual stress testing with cardiologists and was told he was in good shape and even had a zero coronary artery calcium (CAC) score.

However, a CTA scan in Dr. Morales’s office revealed that his friend had diffuse coronary artery disease and a 70 to 80 percent blockage in the mid-right coronary artery (RCA). After aggressive management, follow-up CTA imaging at one year showed a 36 percent decrease in the RCA blockage and stabilization in other arteries, according to Dr. Morales, the owner of South Tampa Cardiology and Advanced Imaging Center in Tampa, Fla.

In a recent interview, Dr. Morales said advances in CTA scanning has led to a significant shift in preventive capabilities with CTA. In addition to significantly lower and more consistent radiation dosing (approximately three millisieverts (mSvs) per CTA scan), Dr. Morales cites the enhanced resolution going from a traditional 64-slice CT scanner to the 560-slice SpotLight CT scanner (Arineta).

“ … The resolution is so much crisper (and) the coronaries are almost still. Now you're able to identify things … such as these soft, 15-mm, 15 percent stenotic plaques that are within the wall that you are missing with the 64-slice CT. The resolution is just so much sharper and, as a result, now you're able to add other pieces of the puzzle, such as artificial intelligence (AI),” noted Dr. Morales.

Dr. Morales said the emergence of adjunctive AI tools with CTA has provided sharper analysis of plaque volume and characteristics.

“AI is leading the way with these advanced CT scanners in a completely new approach to patient care where we can actually identify disease, such as in a screening manner, treat patients, and then we can perform serial surveillance imaging to ensure that treatment is following the path of stabilization or, even in some cases, regression,” posited Dr. Morales.

Can Cardiac CTA be a Viable Alternative for Post-Op Assessment of Left Atrial Appendage (LAA) Closure?

For more insights from Dr. Morales, watch the video below.

In a recent interview, C. Alberto Morales, M.D., discussed the impact of advances with computed tomography angiography and AI, and a shifting emphasis in cardiac risk stratification from stenosis to plaque burden.

Combining Advances in Computed Tomography Angiography with AI to Enhance Preventive Care

In a recent interview, C. Alberto Morales, M.D., discussed the impact of advances with CTA imaging and AI, and a shifting emphasis in cardiac risk stratification from stenosis to plaque burden.

A new study estimates that computed tomography (CT) exams performed in the United States in 2023 will lead to over 100,000 future cases of radiation-induced cancer.

, researchers reviewed data from an estimated 93,000,000 CT exams performed in 2023 for an estimated 61,510,000 patients, including 58,940,000 adults and 2,570,000 children, as well as data from the University of California San Francisco (UCSF) International CT Dose Registry.

Based on current use and radiation dosing levels with CT exams, the study authors estimated that exposure to CT exams performed in 2023 will lead to radiation-induced cancer in 103,000 patients.

While acknowledging that the risk of radiation-induced cancers with CT scans is relatively low, lead study author Rebecca Smith-Bindman, M.D., in a recent interview, emphasized that the projection of radiation-induced cancers is a significant number when considering other risk factors for cancer.

“If we look in the context of cancer in general, if these (CT) dosing practices and utilization practices continue, CT will account for a ballpark of 5 percent of all cancers,” noted Dr. Smith-Bindman, the director of the Radiology Outcomes Research Laboratory and a professor of epidemiology and biostatistics at the UCSF School of Medicine.

“It's not 95 percent, it's not 50 percent but it's a meaningful (number), and it's a number that's comparable to other cancer risk factors that we really think about (like) alcohol consumption (and) obesity, (that) both account for five to 7 percent of cancer. So those are modifiable risk factors that we want to modify to reduce cancers. CT scanning is in that category.”

Dr. Smith-Bindman noted that abdominal and pelvic CT exams accounted for 32 percent of the total number of CT exams in 2023 and were projected to cause 37 percent of the estimated future cases of radiation-induced cancer. Extraneous use of multi-phase scans for routine abdominal CT could be a key target, according to Dr. Smith-Bindman.

“Reducing those multiple phase scans could have a huge impact on reducing the number of future cancers,” maintained Dr. Smith-Bindman.

Deep Learning Denoising May Facilitate Up to a 75 Percent Reduction in Radiation Dosing for Head CT

Can AI Facilitate Single-Phase CT Acquisition for COPD Diagnosis and Staging?

Emerging Strategies for Managing the Acute Shortage of Iodinated Contrast Media

(Editor's note: Graphic in video courtesy of JAMA Internal Medicine.)

For more insights from Dr. Smith-Bindman, watch the video below.

In a recent interview, Rebecca Smith-Bindman, M.D., offered key insights on new research examining the link between computed tomography scans and projected future cases of radiation-induced cancer.

While single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is well validated for the detection of coronary artery disease (CAD) and other cardiovascular abnormalities, there is a degrading effect with attenuation that requires an additional computed tomography (CT) scan to address attenuation compensation.

However, in a recent interview, Abhinav Kumar Jha, Ph.D, noted there are a large number of SPECT scanners that do not have the CT component and this issue is particularly prevalent in community hospitals and rural facilities. Dr. Jha says this problem is compounded as studies have demonstrated a higher prevalence of heart disease in rural health-care settings.

Dr. Jha pointed out that 75 percent of SPECT MPI exams are performed without attenuation compensation and cites a survey of nuclear cardiology providers that found only 5.6 percent provided CT-based attenuation correction.

“Therefore, you can imagine there's a very important need for a large segment of the patient population to have access to this technology of attenuation correction without being able to take a CT scan,” noted Dr. Jha, an associate professor of biomedical engineering and radiology at the Washington University School of Medicine in St. Louis.

However, in recently published research, Dr. Jha and other researchers developed a deep learning technique that provides CT-less (dubbed CTLESS) attenuation compensation. With this research and other studies, Dr. Jha said the CTLESS approach has provided consistent performance across scanner models and patients with different degrees of heart disease.

While acknowledging that more studies are needed to validate the technology, Dr. Jha noted the CTLESS approach has potential to bolster access to SPECT MPI.

“I'm excited about the CTLESS technology (and) making the process of attenuation compensation more accessible, affordable as well as safe,” emphasized Dr. Jha.

Assessing MACE Risk in Women: Can an Emerging Model with SPECT MPI Imaging Have an Impact?

Radiology ‘Game-Changer’: FDA Approves PET Agent for Enhanced Detection of Coronary Artery Disease

Study Shows Merits of CTA-Derived Quantitative Flow Ratio in Predicting MACE

For more insights from Dr. Jha, watch the video below.

Abhinav K. Jha, Ph.D., discusses emerging research for a deep learning CT-less alternative for providing attenuation compensation for SPECT MPI.

Can Deep Learning Provide a CT-Less Alternative for Attenuation Compensation with SPECT MPI?

In a recent interview, Abhinav K. Jha, Ph.D., discussed key challenges with the use of SPECT MRI and how an emerging deep learning model may facilitate attenuation compensation without the need for an additional computed tomography (CT) scan.

While Marfan syndrome is a clinical diagnosis, Alan C. Braverman, M.D., FACC, noted in a recent interview that radiologists play an “invaluable” role in facilitating early diagnosis of this genetic aortic condition.

“They can be the first to put the words into a clinician's mind that this condition that they're seeing on imaging could be something much more,” emphasized Dr. Braverman, the director of the Marfan Syndrome and Aortopathy Center at the Washington University School of Medicine in St. Louis, Mo.

“When there are combinations of findings — root aneurysm, tortuous arteries, mitral valve prolapse — when these features are seen on an imaging study, not just reporting them in diameters accurately, but also suggesting the possibility of something more, like Marfan syndrome or some genetic aortic condition when unexplained in a young person, in particular, can be so helpful to the clinician. It's invaluable.”

For patients with Marfan syndrome, Dr. Braverman emphasized complete assessment of the proximal aorta. Noting that an enlarged aortic root is common in this patient population, Dr. Braverman said the diameter of the aortic root generally exceeds 40 millimeters in younger male patients and 37 millimeters in younger female patients.

While these findings can be visualized very well on echocardiogram, cross-sectional imaging with computed tomography angiography (CTA) or magnetic resonance angiography (MRA) are recommended for initial diagnosis in adult patients and can aid in differentiating between Marfan syndrome and other conditions, such as Loeys-Dietz syndrome, noted Dr. Braverman, a professor of medicine and alumni endowed professor of cardiovascular diseases at the University of Washington School of Medicine.

Improving Adherence to Best Practices for Incidental Abdominal Aortic Aneurysms on CT and MRI

Emerging ECG-Based AI Screening Software for Aortic Valve Stenosis Gets FDA’s Breakthrough Device Designation

Cardiac Ultrasound Update: FDA Clears Software with 45 Automated Parameters for Echocardiographic Analysis

For more insights from Dr. Braverman, watch the video below.

Alan Braverman, MD, discusses the role of radiologists in facilitating the timely diagnosis of Marfan syndrome.

Pertinent Insights into the Imaging of Patients with Marfan Syndrome

Emphasizing the role of radiologists in facilitating timely diagnosis of Marfan syndrome, Alan Braverman, M.D. discussed the use of echocardiography, CT, and MRI in evaluating patients with this genetic aortic condition.

Is it time to revisit initial imaging recommendations in established guidelines for the assessment of chest pain?

For patients with stable chest pain and no prior diagnosis of coronary artery disease (CAD), initial coronary computed tomography angiography (CCTA) was associated with subsequent revascularization in 62 percent of cases in comparison to 31 percent for nuclear stress single photon emission computed tomography (SPECT) testing and 34 percent for no testing, according to a 786-patient study presented at the American College of Cardiology Cardiovascular Summit in Washington, D.C.

In a recent interview, Markus Scherer, M.D., said the study findings show that CCTA offers the most effective tool for evaluating patients with stable chest pain in the absence of a prior CAD diagnosis.

“(Opting for coronary CTA is) a more efficient and more direct pathway to answer the clinician’s question as to whether or not you have coronary artery disease as a cause of your symptoms … and (determining) how much you have is enough to justify taking it to the next level and going to the invasive laboratory,” noted Dr. Scherer, the director ofcardiac CT and structural heart imaging at Atrium Health-Sanger Heart and Vascular Institute in Charlotte, N.C.

Should Dual-Source CT be the New Standard for ER CCTA Assessment of Acute Chest Pain

Could Photon Counting Reduce Iodinated Contrast Media for CT Angiography?

In terms of cost-effectiveness, Dr. Scherer added that coronary CTA, in his clinical experience, typically costs less than the more commonly performed nuclear stress SPECT test and is “certainly less” than direct referrals to the cath lab.

For more insights from Dr. Scherer, watch the video below.

Markus Scherer, M.D., discusses new research on coronary computed tomography angiography (CCTA) and revascularization rates in patients with stable chest pain.

Does Initial CCTA Provide the Best Assessment of Stable Chest Pain?

In a recent interview, Markus Scherer, M.D., discussed emerging research, presented at the American College of Cardiology Cardiovascular Summit, which showed that coronary computed tomography angiography (CTA) was associated with a significantly higher likelihood of revascularization in comparison to other modalities or direct referral for invasive coronary angiography.

For incidental pulmonary emboli (PE) findings on outpatient computed tomography (CT) scans, timely follow-up remains challenging due to daunting radiology worklists and potential health equity considerations, such as transportation access and language barriers, in high-risk populations.

However, in emerging pilot study research presented at the Society for Imaging Informatics in Medicine (SIIM) conference, Ali Tejani, M.D. discussed the implementation of an artificial intelligence (AI)-guided triage software for managing incidental PE findings on computed tomography (CT) scans.

Dr. Tejani and colleagues had impressive results with an approximately one-hour improvement in the median time to emergency department presentation and over a 13-hour difference in the median time to anticoagulant prescription retrieval.

Emerging AI Tool Improves Worklist Triage and CT Detection of Incidental Pulmonary Embolism

Can AI Improve Triage of CT Pulmonary Angiography Exams for Acute PE?

However, Dr. Tejani emphasized that these results wouldn’t have been possible without multidisciplinary collaboration in addressing previously existing challenges in the radiology workflow, including health equity considerations, that affect the quality of care. In collaboration with CT technologists, Dr. Tejani said they established a workflow requirement that patients with outpatient chest CT studies remain at the facility during AI assessment of the imaging. 

The combination of workflow changes with AI-enabled worklist reprioritization for radiologists led to more timely follow-up care for patients with incidental PE findings on CT scans, according to Dr. Tejani, a third-year radiology resident at the University of Texas Southwestern Medical Center.

“By instituting a clinical operations initiative that helps you leverage an AI result, (it) can actually translate to this clinically meaningful change,” noted Dr. Tejani.

For more insights from Dr. Tejani, watch the video below.

In a recent video interview from the Society for Imaging Informatics in Medicine (SIIM) conference, Ali Tejani, M.D., discussed pertinent insights on leveraging the value of adjunctive artificial intelligence (AI)-enabled triage software for computed tomography (CT) scans with radiology workflow improvements to achieve “clinically meaningful change” for patients with incidental pulmonary emboli findings.

Expediting the Management of Incidental Pulmonary Emboli on CT

The purchase of new and cutting-edge imaging equipment comes with a lot of excitement—and a learning curve. That's where Canon Medical Education comes in, providing a host of education solutions for clients that include both in-person and virtual training and continuing education opportunities.

The education arm of Canon Medical Systems USA provides a customizable plan to ensure that all imaging associates are well-trained and comfortable operating advanced equipment including MR and CT, as well as vascular and cath applications, among others. 

Understanding that every learner is different, Canon offers educational opportunities that include in-person, at their Institute of Advanced Imaging in Irvine, California; on-site training at a client facility; online and instructor-led courses in their Canon Learning Center; as well as CE and non-CE webinars and special programs.

To learn more about Canon's educational offerings, 

Canon Medical Systems offer a range of in-person and virtual educational opportunities for their clients. 

Education in Radiology: Canon's Customized Approach

Morris Panner didn’t want to call the familiar PACS system outdated or antiquated. However, he did suggest that radiology is on the cusp of a revolution with medical image and data management that parallels the ongoing emergence of the radiologist from the reading room to being a key member of the interdisciplinary team in facilitating optimal patient outcomes.

“The PACS system is no longer a new invention. It is important and you can always improve it but what people are really looking for now is how to free that data, take that pixel information, share it, use it with other types of data and advance the liquidity and flexibility in data management. That was the revolution that came out of the SIIM (Society for Imaging Informatics in Medicine) meeting this year,” noted Panner, the president of Intelerad Medical Systems, in a recent video interview.

recent survey research showing an increasing patient acceptance of artificial intelligence (AI)

, and the more gradual “try it” phase for many radiologists as they discern the most optimal fit for AI in their current workflows. To that end, Panner also reviewed key aspects of Intelerad’s Enterprise Imaging and Informatics Suite. It is Panner’s hope that by emphasizing improved efficiency and quality in radiology workflows, the system can “free up brain space for great diagnostics.”

For more insights from Morris Panner, watch the video below.

In a video interview, Morris Panner, the president of Intelerad Medical Systems, discussed key observations from the recent Society for Imaging Informatics in Medicine (SIIM) conference, recent research about artificial intelligence (AI) adoption and emerging goals for enhancing the efficiency of radiology workflows.

What's Next in Medical Image and Data Management in Radiology?

Is exposure to iodinated contrast media (ICM) a potential issue for young pediatric patients? The Food and Drug Administration (FDA) recently advised clinicians to ensure thyroid monitoring for patients three years of age and younger within three weeks after exposure to ICM. However, a 

recently published statement from the American College of Radiology (ACR)

 has raised questions about the FDA guidance.

In a recent video interview, Jonathan R. Dillman, M.D., MSc, who co-authored the ACR statement, noted 

several issues with the 11 studies the FDA used to support the guidance

In addition to a lack of prospective data and a lack of control groups in most of the studies cited by the FDA, the majority of the studies focused on high-risk pediatric patients such as low birth weight premature babies, neonates and those with congenital heart disease, according to Dr. Dillman, the associate chief of research in the Department of Radiology and the medical director of the Imaging Research Center within the Division of Radiology at the Cincinnati Children’s Hospital Medical Center.

Dr. Dillman said the FDA guidance is too broad and not supported by the current research.

“Wherever the science takes us, that is where we want to go. The science at this time we do not believe calls for universal thyroid monitoring after intravascular CT (computed tomography) in children three months of age and up. … There is really no evidence to support that,” maintained Dr. Dillman, who has served on the ACR’s Drugs and Contrast Committee since 2007.

For more insights from Dr. Dillman, watch the video below:

In a video interview, Jonathan Dillman, MD, MSc discussed a recently published statement from the American College of Radiology (ACR) that questioned the literature support for a March guidance from the Food and Drug Administration (FDA) about thyroid monitoring for children three years of age or younger within three weeks of exposure to iodinated contrast media (ICM).

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