Journal of Medical Imaging and Radiation Oncology最新文献

{"title":"Measuring Breast Density at Scale With AI: Insights From BreastScreen NSW.","authors":"Richard Walton, Douglas Dunn, Matthew Warner-Smith, Chirag Mistry, Kan Ren, David Roder, Tracey O'Brien","doi":"10.1111/1754-9485.70146","DOIUrl":"https://doi.org/10.1111/1754-9485.70146","url":null,"abstract":"<p><strong>Introduction: </strong>Breast density is a marker of risk both due to the increased burden of fibroglandular tissue, which may harbour malignancy, and to obscuration of lesions in mammography. This study aims to assess the reliability of Lunit INSIGHT MMG as a tool for estimating breast density compared to breast radiologists, evaluate density on a population level of > 600,000 clients, and compare the density in clients with/without implants.</p><p><strong>Methods: </strong>15,518 mammograms were abstracted to explore the intra- and inter-reader reliability between AI and breast radiologists. Variation in density was then evaluated by AI from 624,133 mammograms and stratified according to birth country and age. Finally, density was assessed in 4047 clients with implants and compared to 396,301 clients without implants.</p><p><strong>Results: </strong>AI vs. breast radiologist inter-reader variability weighted kappa coefficient was 0.72 (95% CI 0.71-0.73). Clients with a North-East Asia background had the highest density, whilst clients of Aboriginal background had the lowest density. Density reduced with age across all backgrounds, though at different rates. Clients with implants had higher density than age-matched no-implant strata.</p><p><strong>Conclusion: </strong>AI performed adequately in both intra- and inter-reader reliability. Notable gradients in breast density were observed with increased age but this effect was moderated by ancestry. This study population is significantly larger than any other in the published literature and has considerable diversity in age and ancestry.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Contrast Enhanced Mammography and Digital Breast Tomosynthesis in Patients Suspected of Having Breast Cancer: A Prospective Comparison With Digital Mammography and Breast MRI-Findings of the CONTEST Study.","authors":"Sarah L Savaridas, Kulsam Ali, Sarah Vinnicombe, Petra Rauchhaus, Andrew J Evans, Nisha Sharma, Sally Bolt, Patsy Whelehan","doi":"10.1111/1754-9485.70142","DOIUrl":"https://doi.org/10.1111/1754-9485.70142","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess diagnostic performance and accuracy for local staging of CEM combined with DBT (CE + DBT) compared to digital mammography (DM) and MRI.</p><p><strong>Methods: </strong>Female patients aged 18-70 years with clinical or sonographic suspicion of breast cancer had CE + DBT and breast MRI prior to treatment. Diagnostic accuracy, ability to identify additional disease foci, and disease extent estimations were compared for all imaging techniques. Histopathology was the reference standard.</p><p><strong>Results: </strong>Eighty-seven participants were recruited; 80 included in the study; 69 had cancer. DBT had greater diagnostic sensitivity than DM, but lowest specificity. CEM and CE + DBT showed 100% sensitivity. Specificity was lower for CE + DBT than CEM alone. MRI sensitivity was higher than DM or DBT, but lower than CEM or CE + DBT. MRI specificity was lower than CE-DBT, both separately and in combination. Thirty-nine patients were included in exploratory subset analysis regarding identifying additional foci. DM missed the most cases (8/10); DBT had higher sensitivity but lower specificity; MRI s sensitivity but with more false positives; CEM had the greatest overall accuracy. Thirty patients were included in unifocal disease extent analysis. MRI, CEM, and CE-DBT all demonstrated strong correlation with pathological size, with MRI showing closest agreement.</p><p><strong>Conclusions: </strong>Combined CE + DBT is feasible within a one-stop clinic appointment and may obviate the need for MRI. CEM demonstrated comparable accuracy to MRI, both for diagnostic accuracy and in local staging. We showed no clear benefit to combining morphological information derived from DBT with functional data of CEM compared to CEM alone.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viewpoint: Optimising Cancer Treatment to Reduce Its Environmental Impact","authors":"Robert Chuter,&nbsp;Kari Tanderup","doi":"10.1111/1754-9485.70052","DOIUrl":"10.1111/1754-9485.70052","url":null,"abstract":"<p>It is widely accepted that treatment and care for patients with cancer must and should happen, as it is what everyone would want for themselves and their loved ones. Everyone wants the best possible care, but climate change and the extreme weather that it causes are increasingly affecting everyone including patients in negative ways. To continue giving the best possible cancer care without harming our environment and therefore patients, there is a need to optimise care. Through improving efficiency, reducing travel, using renewable energy and other measures it is possible to limit our environmental impact whilst still giving the best care available. In many cases this creates a win-win-win scenario for patients and the environment and, in many cases, significant cost savings.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"391-394"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sustainability impacts of a web-based outpatient booking application","authors":"Melissa Yeo,&nbsp;Kane Nicholls,&nbsp;Pey Ling Shum,&nbsp;Hamed Asadi,&nbsp;Natalie Yang","doi":"10.1111/1754-9485.13815","DOIUrl":"10.1111/1754-9485.13815","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Climate change is a critical global issue, impacting ecosystems, economies and communities worldwide. The shift from paper-based to digital systems is becoming increasingly prevalent across industries, with downstream positive impacts on sustainability. In 2020, Austin Health, a public tertiary hospital in Victoria, Australia, adopted a web-based outpatient booking application, which succeeded the prior paper-based system. The application served as an integrated platform for administrative staff to access various Austin Information Technology platforms and replaced previous mail-based outpatient appointment notifications with Short Message Service-based notifications. This study aimed to assess the environmental impact and organisation-wide economic cost of a web-based outpatient booking application compared to the prior paper-based system across the same time period.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A retrospective environmental and economic assessment was conducted for both the web-based booking application and the paper-based system. The evaluation covered 36,925 outpatient diagnostic imaging studies – including CT, MRI, ultrasound and mammography – performed at Austin Health from 1st July 2023 until 30th June 2024. The environmental impact was assessed by calculating the expected carbon dioxide equivalent (CO&lt;sub&gt;2&lt;/sub&gt;e) emissions produced by each system. The economic cost analysis was conducted from the perspective of the hospital and included the direct costs of labour and materials/consumables.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;CO&lt;sub&gt;2&lt;/sub&gt;e emissions were significantly reduced using the web-based outpatient booking application compared to the prior paper-based system (38.5 tonnes compared to 0.002 tonnes), predominantly attributable to the elimination of postage-related fuel emissions (27.7 tonnes). The estimated net operating cost savings across the year was at least AUD 175,000 (in 2024 Australian Dollars, adjusted for inflation). This was primarily due to labour savings from the elimination of workflow inefficiencies (at least 2342 h saved) amounting to at least AUD 85,272 in salary, followed by savings from eliminated pathology tests (AUD 57,422) and postage costs (AUD 55,193).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The adoption of the web-based outpatient booking application led to a substantial reduction in carbon emissions and operating costs, alongside enhanced operational efficiency and productivity. These benefits are anticipated to be enduring, especially in the face of an ever-increasing demand for medical imaging services.&lt;/p&gt;\u0000 ","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"345-355"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the Carbon Footprint of External Beam Radiotherapy: Should This Be a Concern for LMICs?","authors":"Afua A. Yorke,&nbsp;Komakech Ignatius,&nbsp;John L. Schreiner,&nbsp;Tomas Kron","doi":"10.1111/1754-9485.70083","DOIUrl":"10.1111/1754-9485.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to estimate the carbon footprint associated with external beam radiotherapy in a low- and middle-income country (LMIC) context, specifically at the Uganda Cancer Institute (UCI), and to evaluate whether sustainability should be a priority alongside treatment access in such radiation therapy settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>A carbon footprint analysis was conducted for patients treated for locally advanced cervical cancer at UCI between 2023 and 2024. The assessment included emissions from three key components: (1) patient travel to and from the facility, (2) pre-treatment imaging using CT and 2D simulation and (3) energy consumption by three Varian TrueBeam linear accelerators during treatment and idle times. Emission estimates were calculated using activity data and standard global warming potential (GWP) conversion factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patient travel emerged as a major contributor to carbon emissions due to the centralisation of services in Kampala and the lack of regional treatment centres. Energy use from LINACs and imaging contributed less significantly, owing in part to Uganda's low-carbon electricity grid powered largely by hydropower. CT scans generated approximately 0.105 kg CO₂ per scan, and LINAC operations added modest emissions depending on usage patterns and machine idle time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While radiotherapy-related emissions in LMICs like Uganda are relatively modest compared to high-income countries, they are non-negligible and expected to rise with growing access to cancer care. Incorporating sustainability considerations into the future planning of radiotherapy infrastructure and service expansion is both feasible and necessary. Carbon-conscious planning should be integrated into decisions around siting and radiotherapy expansion to promote environmentally responsible cancer care in LMICs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"395-400"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imperative for a health-centred focus on climate change in radiology","authors":"Omar Taboun,&nbsp;Chloe DesRoche,&nbsp;Kate Hanneman","doi":"10.1111/1754-9485.13813","DOIUrl":"10.1111/1754-9485.13813","url":null,"abstract":"<p>Climate change negatively impacts individual and population-level health through multiple pathways, including poor air quality, extreme heat and changes in infectious disease. These health effects will lead to higher health system and medical imaging utilisation. At the same time, the delivery of radiology services generates substantial greenhouse gas emissions. Mitigation strategies to reduce the environmental impact of medical imaging and adaptation strategies to build resiliency to current and future impacts of climate change in radiology should be centred on human health. A health-centred response in radiology reinforces the role of radiologists as physicians and emphasises the opportunity for medical imaging to promote health and advance our understanding of climate-related health effects. This review discusses the need for a health-centred focus on climate change in radiology, including the effects of climate change on human health and health systems, intersection of climate change with health equity, health benefits of climate action and opportunities to leverage medical imaging to improve human health.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"356-363"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calculating SF6 Leak Rate in Linear Accelerators From Digital Pressure Logs","authors":"James Everitt","doi":"10.1111/1754-9485.70025","DOIUrl":"10.1111/1754-9485.70025","url":null,"abstract":"<div>\u0000 \u0000 <p>Sulfur Hexafluoride, one of the most potent greenhouse gases, is used in radiation oncology as a dielectric in linear accelerator waveguides. Given the high global warming potential of SF₆, its use is heavily regulated, and possible leaks should be proactively monitored. Truebeam Linac diagnostic log files record SF₆ pressure metrics every 2 h. These log files were parsed, and the high time resolution pressure data were studied across a fleet of 15 Varian Truebeam Linear Accelerators for a 1 year period. Average SF₆ leak rates were low, but highly variable (8.6 g/year/Linac, std dev 17.7 g). Pressure fluctuation due to temperature change was found to be a similar magnitude to real SF₆ losses over months. Leak rates calculated from pressure loss were significantly below those reported in the literature and manufacturer specifications. Pressure fluctuation proportional to temperature change caused by Linac use makes SF₆ pressure an unreliable metric to sample infrequently if the aim is to detect small leaks. A novel method for calculating leak rate using high sample rate log files mitigates this effect, giving a more accurate measurement.</p>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"364-368"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability Perspectives on Radiotherapy Practice","authors":"Ralf Müller-Polyzou,&nbsp;Ioanna Voudouri,&nbsp;Holger Wirtz","doi":"10.1111/1754-9485.70082","DOIUrl":"10.1111/1754-9485.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The reality of rising greenhouse gas emissions and global temperatures underscores the urgency of transitioning to a net-zero energy system. Modern radiotherapy contributes to the total healthcare domain emissions. As the global incidence of cancer rises, expanding treatment capabilities is critical. However, sustainability in high-emission healthcare disciplines is equally paramount. This paper explores the academic knowledge base and practical strategies for understanding and managing emission contributions to align with sustainability goals. The European Union's Corporate Sustainability Reporting Directive and climate disclosure frameworks in Australia and New Zealand require certain organisations, including large hospitals and radiotherapy networks, to report their direct and indirect emissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Climate disclosure frameworks emphasise transparency and resilience to climate risks, supported by methodologies such as the Greenhouse Gas Protocol and ISO 14064. The study narratively examines existing literature and practical solutions through engaged scholarship and provides insights into modelling radiotherapy emissions guided by the principles of the Corporate Sustainability Reporting Directive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Radiotherapy emissions are a small but significant share of healthcare emissions, with indirect emissions dominating. They are estimated at 6.75 Mt. CO_2e, accounting for approximately 0.3% of global healthcare emissions. While sustainable construction and innovative technologies reduce upstream impacts, downstream greenhouse gas reductions remain limited despite travel minimisation efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By advancing sustainability in radiotherapy, this work contributes to the broader healthcare sector's efforts to mitigate climate impacts and aligns with international climate commitments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"378-390"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability in Radiology: Position Paper and Call to Action From ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA","authors":"Andrea G. Rockall,&nbsp;Bibb Allen,&nbsp;Maura J. Brown,&nbsp;Tarek El-Diasty,&nbsp;Jan Fletcher,&nbsp;Rachel F. Gerson,&nbsp;Stacy Goergen,&nbsp;Amanda P. Marrero González,&nbsp;Thomas M. Grist,&nbsp;Kate Hanneman,&nbsp;Christopher P. Hess,&nbsp;Evelyn Lai Ming Ho,&nbsp;Dina H. Salama,&nbsp;Julia Schoen,&nbsp;Sarah Sheard","doi":"10.1111/1754-9485.13842","DOIUrl":"10.1111/1754-9485.13842","url":null,"abstract":"<p>The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (WHO). Climate change, biodiversity loss, and pollution negatively impact all life on earth. All populations are impacted but not equally; the most vulnerable are at highest risk, an inequity further exacerbated by differences in access to healthcare globally. The delivery of healthcare exacerbates the planetary health crisis through greenhouse gas emissions, largely due to combustion of fossil fuels for medical equipment production and operation, creation of medical and non-medical waste, and contamination of water supplies. As representatives of radiology societies from across the globe who work closely with industry, and both governmental and non-governmental leaders in multiple capacities, we advocate together for urgent, impactful, and measurable changes to the way we deliver care by further engaging our members, policymakers, industry partners, and our patients. Simultaneous challenges including global health disparities, resource allocation, and access to care must inform these efforts. Climate literacy should be increasingly added to radiology training programmes. More research is required to understand and measure the environmental impact of radiological services and inform mitigation, adaptation and monitoring efforts. Deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy utilisation, and circular economy. Many solutions have been proposed and are already available, but we must understand and address barriers to implementation of current and future sustainable innovations. Finally, there is a compelling need to partner with patients, to ensure that trust in the excellence of clinical care is maintained during the transition to sustainable radiology. By fostering a culture of global cooperation and rapid sharing of solutions among the broader imaging community, we can transform radiological practice to mitigate its environmental impact, adapt and develop resilience to current and future climate and environmental threats, and simultaneously improve access to care.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"369-377"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13842","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special Issue on Sustainability","authors":"Warren Clements,&nbsp;Tomas Kron,&nbsp;Nicholas Hardcastle,&nbsp;Jeremy Millar,&nbsp;Gabriel Lau","doi":"10.1111/1754-9485.70136","DOIUrl":"https://doi.org/10.1111/1754-9485.70136","url":null,"abstract":"&lt;p&gt;The environmental impact of medical imaging and image-guided therapy is tangible, and we are staring at the direct result of our actions [&lt;span&gt;1&lt;/span&gt;]. Both the World Health Organisation and United Nations stress climate change as a matter of urgency [&lt;span&gt;1&lt;/span&gt;]. Healthcare is an essential service to the Australian and New Zealand population; however, both medical imaging and radiotherapy are significant contributors to greenhouse gas emissions in Australia, specifically CT and MRI services [&lt;span&gt;2&lt;/span&gt;]. Provision of services requires modern technology, which brings a climate impact regardless of how it is implemented. Thus, it is imperative that a top-down plan is made to transform new and existing services to a low-carbon footprint.&lt;/p&gt;&lt;p&gt;In this special issue on sustainability, the Journal of Medical Imaging and Radiation Oncology (JMRO) introduces several key topics that the editors consider to be paramount to our readership based on current and future practice. This includes key domains of advocacy, global disparities, education, toolkits, research, preparedness, industry collaboration, and patient collaboration [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;From the perspective of radiation oncology, the issue considers the impact of existing radiotherapy services [&lt;span&gt;4, 5&lt;/span&gt;] including governance and quality control of sulfur hexafluoride [&lt;span&gt;6&lt;/span&gt;], and the practicalities of cancer treatment within daily life [&lt;span&gt;7&lt;/span&gt;]. For diagnostic imaging, this issue addresses the impact of climate change on medical imaging delivery, health equity, and even proposes digital mitigation strategies [&lt;span&gt;1, 8&lt;/span&gt;]. In considering the impact of interventional radiology, the issue assesses the broad role of facility design, energy and waste management, and the use of disposable equipment [&lt;span&gt;9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Sustainable approaches to healthcare delivery are now not only mandatory but also achievable, and must be purpose-designed using top-down governance changes [&lt;span&gt;9&lt;/span&gt;]. This underpins the Royal Australian and New Zealand College of Radiologists' (RANZCR) endorsement of the multi-society position paper and call to action on sustainability [&lt;span&gt;3&lt;/span&gt;]. However, we cannot leave this to colleges and societies on their own to tackle. There still must be buy-in from local health networks, medical practitioners, and our patients, where healthcare is ultimately delivered [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This special issue coincides with a joint announcement from RANZCR and JMIRO that the journal is to transition to a fully digital platform, beginning in 2027 [&lt;span&gt;11&lt;/span&gt;]. This transition marks a significant change in practice for the journal and aligns with several of the sentiments in the attached articles. It will modernise how articles are published and disseminated, providing quicker publication and easier access to viewing platforms. It may also contribute to how we view the performance of articles in the future, with views and ","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 4","pages":"343-344"},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.70136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}