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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

While a CT-based deep learning model demonstrated a 91 percent AUC for predicting lung cancer risk within one year, researchers noted other mixed results in a new study involving over 18,000 individuals.

Can Deep Learning Enhance Low-Dose Chest CT Assessment of Lung Cancer Risk?

Computed tomography colonography (CTC) demonstrated a 91.6 percent positive predictive value (PPV) for polyps > 6 mm, according to new research involving over 9,000 patients who underwent CTC for primary asymptomatic colorectal cancer screening.

Twenty Years of CT Colonography for Colorectal Cancer Screening: What the Research Reveals

Developed by 21 thoracic radiologists, the new international consensus statement addresses appropriate indications, scan acquisition and keys to reporting for the use of chest CT imaging in evaluating for residual lung abnormalities from COVID-19.

Chest CT for Post-COVID-19 Abnormalities: Nine Takeaways from a Multi-Society Consensus Statement 

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.

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.

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.

For busy neuroradiology departments, adjunctive artificial intelligence (AI) may facilitate timely detection and triage of computed tomography (CT) scans showing subdural hematomas (SDHs).

In a new retrospective multicenter study presented at the International Stroke Conference (ISC), researchers compared the AI-powered Rapid SDH (RapidAI) software versus three expert neuroradiologist assessments of non-contrast-enhanced head CTs in 313 patients (mean age of 63) for the detection of SDH.

The researchers found that the AI software provided a 92.4 percent sensitivity and a 98.7 percent specificity for subdural hematomas. Specifically, the Rapid SDH software offered a 91.5 percent sensitivity for chronic SDH and a 92.7 percent sensitivity for acute/subacute SDH, according to the research.

In a recent interview from the ISC, lead study author Jeremy Heit, M.D., Ph.D., spoke about the potential impact of the research.

“Those are really good numbers. This is a hard problem, and as one of the readers, some of these hemorrhages were really subtle,” noted Dr. Heit, the chief of neuroimaging and neurointervention at the Stanford University School of Medicine. “So the fact that they're being picked up, I actually think that's really impressive because it's not a trivial task for a computer to be able to deal with.”

Bringing up an example of multiple traumas requiring a number of acute imaging scans in an emergency department, Dr. Heit said the accuracy and efficiency of the Rapid SDH software can have a significant impact in triaging important cases.

“I think it's really going to be helpful to have it work that quickly. It's a three-minute processing (time) to be able to flag something and bump it up on your queue. That is super helpful,” maintained Dr. Heit.

FDA Clears AI-Powered Module for Detecting Hemispheric Subdural Hematomas on CT

Key Findings on Non-Contrast CT Signal Higher Complication Risks in Patients with Intracerebral Hemorrhage

FDA Clears New AI Tool for Diagnosing Subdural Hemorrhage

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

Neuroradiologist Jeremy Heit, MD, discussed new research showing the efficacy of the AI-powered software Rapid SDH for detecting subdural hematomas on non-contrast head CT scans.

Employing AI in Detecting Subdural Hematomas on Head CTs: An Interview with Jeremy Heit, MD, PhD

1. Heit J. Performance of Rapid SDH for detection of both acute and chronic subdural hematomas. Presented at the International Stroke Conference, February 4-7, 2025, Los Angeles. For more info, visit 

https://professional.heart.org/en/meetings/international-stroke-conference

In a video interview from the International Stroke Conference (ISC), Jeremy Heit, M.D., Ph.D., discussed new research revealing over 90 percent sensitivity and specificity rates for AI detection of subdural hematomas on non-contrast-enhanced head CTs.

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.

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