Richard White

Economics
RBMA: What the midterm election results mean for radiology
What does the Republican Party's resounding win in Tuesday's midterm elections mean for radiology? The Radiology Business Management Association (RBMA) and its legislative affairs advisors have been following the election and offer an analysis.
November 5, 2014
2014 02 26 18 14 31 705 Capitol Hill 200
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Molecular Imaging
SPECT/CT access unequal across U.S.
At the state level, California, Texas, and Florida had the highest number of facilities in absolute terms.
Example of AI-assisted pulmonary nodule detection and longitudinal volumetric assessment in a 65-year-old woman with peripheral arterial disease, a 24-pack-year smoking history, emphysema, and a family history of lung cancer. An incidental 8.5-mm right lower lobe pulmonary nodule is identified at CT angiography of the abdomen in July 2022 but does not receive follow-up. Subsequent imaging demonstrates interval growth, and CT-guided biopsy confirms stage IA lung adenocarcinoma. Contrast-enhanced axial chest CT images obtained on February 2, 2024, before robotic-assisted thoracoscopic segmentectomy, show a 12.1-mm spiculated right lower lobe pulmonary nodule. (A) Conventional contrast-enhanced axial chest CT image without AI assistance shows a 12.1-mm spiculated right lower lobe pulmonary nodule. (B) Corresponding CT image with AI-assisted pulmonary nodule detection, automated segmentation, and quantitative nodule assessment identifies a solid pulmonary nodule (nodule #1) measuring 13 × 8 (11) mm, with a volume of 739 mm3, a 45% volumetric increase compared with the previous contrast-enhanced chest CT performed on October 9, 2023 (510 mm3), and an estimated volume doubling time (VDT) of 216 days. (C) AI-generated longitudinal nodule analysis displays automated segmentation of the current (February 2, 2024) and previous (October 9, 2023) CT examinations, 3D nodule reconstruction, and quantitative volumetric assessment for longitudinal follow-up. The AI interface is displayed in the original software language (Dutch).
CT
AI cuts chest CT reporting time
Detection and extent of BI-RADS suspicious calcifications (amorphous, coarse heterogeneous, fine pleomorphic, and fine linear or fine linear branching) at axial photon-counting CT (PCCT) versus full-field digital mammography (first three images, craniocaudal view; last image, mediolateral oblique view). Calcifications found on mammography showed only partial visualization at ultrahigh-resolution PCCT (0.2 mm), while amorphous calcifications could not be distinguished from image noise. Corresponding abnormal enhancement was clearly depicted on contrast-enhanced PCCT images.
Womens Imaging
PCCT on par with MRI for diagnostic breast imaging
Radiological Report 400
Practice Management
Self-interpreting by ordering clinicians tied to low-value imaging
Ultrasound Portable 400
Ultrasound
POCUS improves timeliness in emergency pregnancy care
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SPECT/CT access unequal across U.S.
By Will Morton
At the state level, California, Texas, and Florida had the highest number of facilities in absolute terms.
September 1, 2026
Shutterstock 2028051956 (1)
AI cuts chest CT reporting time
By Will Morton
Exploratory modeling suggested an approximate reduction of 0.5 full-time equivalent radiologist workload.
September 1, 2026
Example of AI-assisted pulmonary nodule detection and longitudinal volumetric assessment in a 65-year-old woman with peripheral arterial disease, a 24-pack-year smoking history, emphysema, and a family history of lung cancer. An incidental 8.5-mm right lower lobe pulmonary nodule is identified at CT angiography of the abdomen in July 2022 but does not receive follow-up. Subsequent imaging demonstrates interval growth, and CT-guided biopsy confirms stage IA lung adenocarcinoma. Contrast-enhanced axial chest CT images obtained on February 2, 2024, before robotic-assisted thoracoscopic segmentectomy, show a 12.1-mm spiculated right lower lobe pulmonary nodule. (A) Conventional contrast-enhanced axial chest CT image without AI assistance shows a 12.1-mm spiculated right lower lobe pulmonary nodule. (B) Corresponding CT image with AI-assisted pulmonary nodule detection, automated segmentation, and quantitative nodule assessment identifies a solid pulmonary nodule (nodule #1) measuring 13 × 8 (11) mm, with a volume of 739 mm3, a 45% volumetric increase compared with the previous contrast-enhanced chest CT performed on October 9, 2023 (510 mm3), and an estimated volume doubling time (VDT) of 216 days. (C) AI-generated longitudinal nodule analysis displays automated segmentation of the current (February 2, 2024) and previous (October 9, 2023) CT examinations, 3D nodule reconstruction, and quantitative volumetric assessment for longitudinal follow-up. The AI interface is displayed in the original software language (Dutch).
PCCT on par with MRI for diagnostic breast imaging
By Amerigo Allegretto
PCCT performed similarly to MRI for characterizing breast lesions and finding additional lesions.
September 1, 2026
Detection and extent of BI-RADS suspicious calcifications (amorphous, coarse heterogeneous, fine pleomorphic, and fine linear or fine linear branching) at axial photon-counting CT (PCCT) versus full-field digital mammography (first three images, craniocaudal view; last image, mediolateral oblique view). Calcifications found on mammography showed only partial visualization at ultrahigh-resolution PCCT (0.2 mm), while amorphous calcifications could not be distinguished from image noise. Corresponding abnormal enhancement was clearly depicted on contrast-enhanced PCCT images.
Self-interpreting by ordering clinicians tied to low-value imaging
By Amerigo Allegretto
Visits involving clinicians who self-interpreted all their ordered imaging had higher odds of imaging overall.
September 1, 2026
Radiological Report 400
POCUS improves timeliness in emergency pregnancy care
By Amerigo Allegretto
Emergency POCUS can reduce length of stay and time to diagnosis while not leading to more missed diagnoses of ectopic pregnancy.
August 31, 2026
Ultrasound Portable 400
Bayer's PET agent meets endpoints in phase III cardiac amyloidosis study
By Will Morton
Overall sensitivity was 94% (95% CI, 85% to 98%) and specificity was 86% (95% CI, 77% to 92%).
August 31, 2026
This figure shows fused I-124 evuzamitide positron emission tomography (PET)/computed tomography (CT) images from patients without amyloidosis and from patients with ATTR cardiac amyloidosis, early ATTR cardiac amyloidosis, light chain cardiac amyloidosis, gelsolin-mediated amyloidosis, and systemic organ amyloid. The columns represent radiological transaxial, sagittal, and coronal views except for the last row middle and far right columns, which are coronal projections. The blue asterisks represent physiological activity (tracer activity in the stomach and esophagus). The arrowheads represent pathological uptake. Note the small amount of cardiac uptake in the basal septum and the basal lateral walls (likely early ATTR cardiac amyloidosis), splenic uptake and pleural uptake in light chain amyloidosis, and cardiac and kidney uptake in gelsolin-mediated amyloidosis. The bright yellow color represents more tracer uptake.
MRI-based biomarker tool can predict progression to dementia
By Amerigo Allegretto
The tool measures gray matter shrinkage in the brain, predicting when mild cognitive impairment progresses to dementia.
August 28, 2026
Brain 400
Is nitroglycerin necessary prior to photon-counting CT?
By Will Morton
Sublingual nitroglycerin is routinely administered before CCTA to induce coronary vasodilation.
August 27, 2026
Representative case from the non-nitroglycerin cohort. A 92-year-old man who did not receive sublingual nitroglycerin because of severe aortic stenosis. The Agatston coronary artery calcium score was 5438. (A) Curved multiplanar reformatted CCTA image reconstructed at 0.4-mm slice thickness using a Bv60 kernel and QIR strength 3 demonstrates diffuse multifocal mild luminal stenoses related to extensive calcified atherosclerotic plaque. (B) Invasive coronary angiography confirmed multifocal mild stenoses without evidence of obstructive coronary artery disease.
PET outperforms CT in ovarian cancer
By Will Morton
Peritoneal carcinomatosis in ovarian cancer is cancer that has spread from the ovaries to the peritoneum.
August 28, 2026
Comparison of contrast-enhanced CT (ceCT) and FAPI-PET in detecting peritoneal carcinomatosis in patient with advanced ovarian carcinoma. (A) ceCT shows subtle peritoneal thickening that is difficult to delineate. (B) Maximum-intensity-projection image demonstrating diffuse intense FAPI uptake corresponding to extensive peritoneal carcinomatosis. (C) FAPI-PET shows intense uptake corresponding with peritoneal carcinomatosis, with improved lesion conspicuity over ceCT.
Advanced ultrasound techniques improve soft tissue tumor evaluation
By Amerigo Allegretto
Both SWE and SMI can help distinguish benign from malignant soft tissue tumors.
August 26, 2026
Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.
Sustainability efforts should look to state power grids
By Amerigo Allegretto
Variation in grid carbon intensity by state drives per-beneficiary greenhouse gas emissions from MRI and CT use.
August 28, 2026
Choropleth map of state-level imaging-associated greenhouse gas emissions per 1,000 Medicare Part B fee-for-service beneficiaries in 2022. Darker shades indicate higher per-beneficiary greenhouse gas emissions. District of Columbia (not shown) is in 3-4 MTCO2e per 1,000 range. MT CO₂e = metric tons of carbon dioxide equivalent
Women's Imaging MinnieCast, Episode 16: Breast AI expectations versus performance
By Amerigo Allegretto
Azadeh Elmi, MD, shares results showing how breast imaging AI tools have modest clinical benefit in practice over expectations.
August 28, 2026
Minnie Cast Thumbnail (21)
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