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Patients who underwent low-dose CT for lung cancer screening and received false-positives benefited from counseling.

LDCT for Lung Cancer Screening: The Effect of False-Positives

Low-dose CT lung cancer screening detects more early cancers in at-risk patients than radiography, but with lower positive predictive value.

Two Low-Dose CT Annual Screenings May Detect Early Lung Cancer

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 Boston.

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 Boston.

 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.

COVID-19 halted all cancer screening services at the beginning of the pandemic, and slowly those scans have become more and more available -- but, not necessarily for everyone.

In many instances, racial and minority patients continue to face the same healthcare disparities that made it difficult for them to access the services at the outset. Now, the fear and trepidation associated with the pandemic are layered on top. 

Despite these difficulties, there are things healthcare institutions and providers can do to help. In this episode of 

 spoke with Shalmon Kalnicki, M.D., chair of radiation and oncology at Montefiore and Albert Einstein College of Medicine about the challenges these patients continue to face with cancer screenings. Not only did he share with us how COVID-19 has impacted this existing problem, but he also outlined the steps institutions can take to improve this situation.


In this podcast episode, Dr. Shalom Kalnicki, from Montefiore and Albert Einstein College of Medicine, discusses the disparities minority patients face with cancer screenings and what can be done to increase access during the pandemic.

The Reading Room: Racial and Ethnic Minorities, Cancer Screenings, and COVID-19

Current lung cancer screening guidelines could be overlooking African American smokers who are at risk for developing lung cancer.

According to a study published in the Sept. 15 

Journal of the American College of Radiology

 the current guideline based on the 30-pack-year threshold sets the bar too high, as most African American smokers self-report a less than 30 pack-year history. This determination sounds an alarm bell because African Americans have a high incidence of and worse outcomes from lung cancer.

“There is growing concern that there are healthcare disparities in lung cancer screening guidelines and programs,” said lead study author Anupam Basu, M.D., a diagnostic radiologist in Cook County Health. “Evidence suggests that the National Lung Screening Trial (NLST) and Preventive Services Take Force inclusion threshold of a 30-pack-year smoking history excludes a portion of African American patients at risk for lung cancer.”

Even though African Americans are more significantly impacted by lung cancer, the team said, they still only account for 4 percent of the NLST. Based on existing evidence this group does have a smoking duration history similar to their white counterparts – but, they actually smoke fewer packs a day. Consequently, they have a shorter pack history – the benchmark providers use to determine who should undergo lung cancer screening.

The team, therefore, suggested lung cancer screenings would be much more accurate and impactful if they adopted a 20-pack-year threshold.

To subscribe to The Reading Room podcast, click 

To identify a threshold that could better identify more African American smokers who could benefit from lung cancer screening, the team retrospectively reviewed low-dose CT scans from patients in their public hospital between September 2017 to December 2019. 

All total, they reviewed data from 784 patients, 57.5 percent of whom were men with an average age of 62. The majority were African American (66.2 percent), followed by white (20.4 percent), Hispanic (8.3 percent), Asian (4.8 percent), and Native American (0.3 percent).

Of the group, three-quarters – 75.5 percent – were active smokers, and just more than half – 51.5 percent revealed a pack history of fewer than 30 years. Total years smoked did not vary much by race, the team said. But, the African American experience was somewhat different, and it painted a grim picture.

“African Americans smoked fewer packs per day and had fewer pack-years compared with other races,” the team said. “African Americans were more likely to be active smokers but also more likely to report [less than] 30 pack-years compared with other races.”

Low-dose CT findings determined that lung cancer incidence did not vary by race, but African American had an incidence of 2.5 percent while whites experience 1.9 percent. Fortunately, the majority of cancers identified (75 percent) were Stage 1, and all patients had the cancerous tissues successfully removed with surgery.

Looking at lung cancer diagnosis specifically in the context of smoking brought more bad news. African Americans were the only race diagnosed with lung cancer when their self-reported pack-year history was less than 30. For smokers in this group with more than 30-pack-year histories, the incidence rate was 2.2 percent. For those with less than 30 years, it was 2.7 percent.

“We are concerned that the 30-pack-year threshold in the African American population may exclude a portion of patients who are still at risk for lung cancer,” the team said. “We propose prospective study of African Americans with [less than] 30-pack-year histories to determine the potential benefits and harms of [lung cancer screening] in this unique underserved population.”

For more coverage based on industry expert insights and research, subscribe to the Diagnostic Imaging e-Newsletter

In this podcast, Dr. Anupam Basu from Cook County Health in Chicago discusses the 30-pack-year threshold for lung cancer screening that overlooks at-risk African American smokers.

The Reading Room: Lung Cancer Screening Misses At-Risk African American Smokers

Lung injuries caused by vaping leave signature marks on CT scans, a follow-up study has revealed, arming radiologists with the details needed to potentially make more accurate diagnoses and help patients avoid unnecessary biopsies.

 a team led by Michael Gotway, M.D., a radiologist at the Mayo Clinic in Arizona, laid out their findings that show these lung injuries – called EVALI (electronic cigarette or vaping product use-associated lung injury) – produce patterns on chest CT scans that correlate with previously observed pathological findings.

The first reports of EVALI surfaced last year from the Centers for Disease Control & Prevention. Within the first six months after this report, almost 3,000 EVALI-related hospitalization were recorded, as well as 68 confirmed deaths. Almost all patients present with complaints of shortness-of-breath, chest pain, and constitutional symptoms that can resemble viral illness. The non-specific nature of these symptoms can make an accurate diagnosis difficult.

 Chest Imaging Reveals Traits of Vaping-Related Lung Injuries in Teens

Based on their findings, he said, 96 percent of patients exhibited multi-focal or diffuse ground-glass opacities and consolidation that involves most or all lobes bilaterally and could involve mild interlobular septal thickening and subpleural sparing. As the illness evolves, imaging findings can suggest mild architectural distortion, intralobular lines, lobular distortion, and traction bronchiectasis.

These findings can be particularly helpful, he said, when providers are imaging younger patients with chest pain and shortness-of-breath. In those cases, a diagnosis of EVALI should be strongly considered.

Even though patients may be reticent to admit they are vaping, he said, if a radiologist recognizes one of these patterns on CT, he or she can advise the clinician, potentially leading to a nicotine metabolite test and further questions about exposure. Employing that approach could help patients avoid the invasiveness, time, expense, and risk associated with unnecessary biopsies.

“These radiological findings will be especially beneficial to physicians to help them determine potentially less invasive treatment options,” Gotway said. “We could potentially make that diagnosis non-invasively through cooperation with our clinical colleagues. By alerting them to a scan pattern that is suggestive of the possibility of EVALI, we may actually save patients from having to meet a surgeon.”

Michael Gotway, M.D., cardiopulmonary radiologist with the Mayo Clinic, discusses the signature signs of EVALI on CT scans in this podcast.

The Reading Room: Signature Signs of EVALI on CT

Emerging research shows that a multiple time-series deep learning model assessment of CT images provides 20 percent higher sensitivity than a delta radiomic model and 56 percent higher sensitivity than a clinical model for prognostic evaluation of ground-glass nodules.

Can CT-Based Deep Learning Bolster Prognostic Assessments of Ground-Glass Nodules?

Researchers also noted a greater than 30 percent increase in treatment management changes resulting from the use of CT-based adjunctive AI to detect lung metastases in colorectal cancer patients.

Adjunctive AI Leads to 40 Percent Increase in CT Sensitivity for Lung Metastases in Patients with Colorectal Cancer

Emerging research suggests the use of computed tomography colonography (CTC) in colorectal cancer screening may provide significantly higher preventive benefit at lower costs in comparison to multitarget stool DNA testing.

Study: CT Colonography Screening Offers Up to 16 Percent Higher Reduction of Colorectal Cancer Incidence than Cologuard 

In a review of 155 studies, researchers examined the capabilities of photon-counting computed tomography (PCCT) for enhanced accuracy, tissue characterization, artifact reduction and reduced radiation dosing across thoracic, abdominal, and cardiothoracic imaging applications.

Photon-Counting Computed Tomography: Eleven Takeaways from a New Literature Review 

In never-smokers, deep learning assessment of single baseline low-dose computed tomography (CT) scans demonstrated a 79 percent AUC for predicting lung cancer up to six years later, according to new research presented today at the American Thoracic Society (ATS) 2025 International Conference.

Can AI Predict Future Lung Cancer Risk from a Single CT Scan?

The statistics on colon cancer continue to be troubling. Colorectal cancer (CTC) is reportedly the third leading cause of death among African Americans, and there has been an increasing incidence of CTC among people under the age of 50.

, researchers noted increasing annual incidence rates of colorectal adenocarcinoma among people 15 to 50 years of age.

In a recent interview. Syam Reddy, M.D., discussed these trends and lamented that screening is only being done for approximately 60 percent of those at risk for colon cancer.

“Our screening efforts need to expand. And to do that, we just need to have more opportunities that people have available for screening. That's what makes CT colonography such an ideal exam for these screening tools. You know, some of the tools out there, they screen for cancer, but not for pre-cancerous lesions. That's a huge advantage for CT colonography as well as the optical colonoscopy. Both of those are pretty equivalent when it comes to cancer detection or pre-cancer detection,” maintained Dr. Reddy, the clinical chairman at the UChicago Medicine Ingalls Memorial Hospital in Harvey, Ill.

With this in mind, Dr. Reddy recently developed a 

 with Radiology Partners for incorporating CTC into radiology practice. Dr. Reddy describes it as a resource that compiles available information on CTC for technologists, radiologists, patients, and administrators.

“The reason for doing that is we really wanted to, in this crazy, busy world, allow for some kind of resource for our radiologists to be able to pick this up and share it with their local sites, because it's such an important way to help our population on a bigger scale,” explained Dr. Reddy, who is affiliated with Radiology Partners, and is the current president of the Chicago Radiological Society.

Could Lymph Node Distribution Patterns on CT Improve Staging for Colon Cancer?

Survey Results Reveal Doubling of CT Colonography Use During COVID-19 Pandemic

Study: Deep Learning Reconstruction Reduces Effective Dosing for CT Colonography by 83 Percent

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

In a recent interview, Syam Reddy, MD discusses trends with the rising incidence of colon cancer and a new clinical pathway resource to facilitate implementation of CT colonography into radiology practice.

Incorporating CT Colonography into Radiology Practice

1. Saka AH, Giaquinto AN, McCullough LE, et al. Cancer statistics for African American and Black people. 2025. 

. Published February 20, 2025. Accessed April 21, 2025.

2. Bussetty A, Shen J, Benias PC, Ma M, Stewart M, Trindade J. Incidence of pancreas and colorectal adenocarcinoma in the U.S. 

 2025:8(4):e254682. doi:10.1001/jamanetworkopen.2025.4682 .

In a recent interview, Syam Reddy, M.D., discussed the rising incidence of colon cancer and a clinical pathway resource with Radiology Partners that facilitates the integration of computed tomography colonography (CTC) into radiology practice.

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.

One of the ongoing trends with the development of artificial intelligence (AI) modalities in radiology is an increasing emphasis on improving efficiencies with non-interpretative tasks.

In a recent interview, Sonia Gupta, MD said the combination of AI and natural language processing can help retrieve and analyze key historical points from a patient’s electronic medical record (EMR). Dr. Gupta emphasized that this technology could help streamline patient triage, radiology reporting and the management of incidental finding follow-up.

“(With) incidental finding follow-up, AI reads the report and detects the findings that need follow-up … and can also insert the follow-up recommendations for you into the report. Again, this is all non-interpretative and natural language processing-based type of AI. I think that is a really great opportunity we can all utilize,” maintained Dr. Gupta, an abdominal radiologist, a board member of the American Board of Artificial Intelligence in Medicine, and the chief medical officer of Change Healthcare.

Emerging Insights on Improving Radiology Workflows

Assessing the Value Proposition of AI in Radiology

AI in Radiology: Top Five Articles of 2022

Dr. Gupta said the hope is that this emphasis on simplifying non-interpretative tasks could reduce time-consuming elements of radiology workflows and help curtail burnout.

Noting that approximately one-third of radiologists are currently utilizing some form of AI in practice, Dr. Gupta said the combination of cancer screening with AI and appropriate reimbursement could accelerate AI adoption in radiology.

Pointing out there are currently upward of 200 Food and Drug Administration (FDA) 510(k) clearances in radiology, Dr. Gupta said the ongoing consolidation of AI vendors may make it easier for radiologists to choose among relevant systems for their practice. She added that consolidation could be a boon for early adopters, who may gain access to more AI offerings than they originally signed up for.

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

In a recent video interview, Sonia Gupta, MD discussed a number of ongoing developments with artificial intelligence (AI) in radiology, ranging from market consolidation of AI vendors to maximizing automation and efficiency with patient triage, reporting and follow-up of incidental findings.

Emerging Trends with AI in Radiology in 2023

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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