Journal of the American College of Radiology : JACR最新文献

{"title":"Measuring the Environmental Impact of MRI and CT: A Life Cycle Assessment.","authors":"Diana E Carver, Sumit Pruthi, Olesya Struk, Marta Vigil-Garcia, Cecilia Meijer, Josephine Gehrels, Reed A Omary, John R Scheel, Cassandra L Thiel","doi":"10.1016/j.jacr.2025.09.030","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.030","url":null,"abstract":"<p><strong>Objective: </strong>To assess the environmental impact of magnetic resonance (MR) and computed tomography (CT) imaging using life cycle assessment (LCA), focusing on energy use, resource consumption, and emissions.</p><p><strong>Methods: </strong>This ISO 14040-guided LCA-based study focused on MRI and CT services, including the production and use of three MRI and four CT scanners, at a quaternary care 800-bed academic medical center in the Southeastern USA over a one-year period. Data were collected through direct observation, record review, staff interviews, and energy metering. Environmental impacts were assessed using SimaPro 9.3.0.2 and the Ecoinvent v3.8 database.</p><p><strong>Results: </strong>MRI and CT services at this site generate an estimated 221 and 108 tons of CO2e per year, respectively. This is equivalent to the emissions of 52 (MRI) and 25 (CT) cars driven annually. Energy consumption accounted for the largest portion of emissions (58% for MRI, 33% for CT), followed by disposable supplies (26% for MRI, 16% for CT), capital equipment production (7% for MRI, 13% for CT), and linens (4% for MRI, 11% for CT). Switching to solar photovoltaic electricity could reduce total MRI emissions by 70% and CT emissions by 40%, increasing the relative impacts of scanner production, disposable supplies, and linens.</p><p><strong>Discussion: </strong>This study highlights the significant environmental impact of MRI and CT services, particularly energy consumption. Renewable energy sources, such as solar photovoltaics, offer the greatest potential for mitigating the environmental footprint. Additional strategies include optimizing scanner utilization, adopting reusable or reprocessable supplies, and embracing circular business practices such as circular manufacturing and extending the lifespan of capital equipment.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent trends in diagnostic radiology application and match rates.","authors":"Dheeman Futela, Sachi Malhotra, Seyedmehdi Payabvash, Dhairya A Lakhani, Dheeraj Gandhi, Achala Vagal, Max Wintermark, Ajay Malhotra","doi":"10.1016/j.jacr.2025.09.033","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.033","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess recent trends in diagnostic radiology residency positions, rates of applications per applicant, application burden for programs, match probability rates and impact of preference signaling on the match process.</p><p><strong>Methods: </strong>The ERAS National applicant statistics from 2020 to 2025 were used to collect the total number of applicants to Diagnostic Radiology programs, along with the average applications submitted per applicant, and average application count received per program. The biennial NRMP \"Charting Outcomes in the Match\" report was used to collect total positions offered in the Match, number of applicants who participated in the Match with Diagnostic Radiology as the preferred specialty, (Active match applicants), number of matched and unmatched applicants and the mean number of contiguous ranks by matched and unmatched applicants.</p><p><strong>Results: </strong>Between 2020 to 2025, the total number of ERAS applicants who applied to DR programs increased by 9.4% while the number of positions offered in the match increased by 11.3%. The proportion of US MDs out of all ERAS applicants increased from 56.3% (1068/1897) in 2020 to 59.2% (1230/2076) in 2025. The average applications submitted per applicant increased by 30.4% while the average number of applications received per program increased by 65.8% between 2020 and 2023. Match year 2022 had the greatest value of mean contiguous ranks (14.9), observed magic number (13.2) and normalized magic number (12.2). The number of applications per applicant, applications received by programs, number of interviews and contiguous ranks have all decreased with the introduction of preference signaling since 2023.</p><p><strong>Discussion: </strong>Our study results show that there was a significant increase in average applications submitted in the past 5 years, especially between 2018 and 2023. Introduction of preference signaling and geographic preferences in the ERAS application process has achieved the desired effect of reducing congestion given the high volume of applications and interviews. Match competitiveness increased sharply between 2016-2018 with no subsequent consistent trend.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harmonizing Diagnostic Ultrasound Practice with Environmental Sustainability: A Life Cycle Assessment of Diagnostic Ultrasound in a Single Adult University Hospital.","authors":"Katherine Frederick-Dyer, Cassandra L Thiel, Jessica R Leschied, Olesya Struk, Marta Vigil-Garcia, Cecilia Meijer, Josephine Gehrels, Reed A Omary, John R Scheel, Diana E Carver","doi":"10.1016/j.jacr.2025.09.031","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.031","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hidden Impact of Radiography and Fluoroscopy-An Environmental Life Cycle Assessment.","authors":"Elizabeth J Snyder, Cassandra L Thiel, Olesya Struk, Marta Vigil-Garcia, Cecilia Meijer, Josephine Gehrels, Reed A Omary, John R Scheel, Diana Elizabeth Carver","doi":"10.1016/j.jacr.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.020","url":null,"abstract":"<p><strong>Objective: </strong>To assess the environmental impact of radiography and fluoroscopy, using life cycle assessment (LCA), focusing on energy use and emissions.</p><p><strong>Methods: </strong>This ISO 14040-guided LCA-based study focused on radiography and fluoroscopy services, including the production and use of two radiography and two fluoroscopy machines, at a quaternary care 800-bed academic medical center in the Southeastern United States over a 1-year period. Data were collected through direct observation, record review, staff interviews, and energy metering. Environmental impacts were assessed using SimaPro 9.3.0.2 and the Ecoinvent v3.8 database.</p><p><strong>Results: </strong>Radiography and fluoroscopy activities generated an estimated 55,100 kilograms of CO₂ equivalents (kg CO₂e) per year. Energy use was the main contributor (47%), with fluoroscopy having much higher per-scan emissions (4.8 and 9.6 kg CO₂e per scan) than radiography (0.8 kg CO₂e per scan). Medical linens or textiles accounted for 24% of total emissions. Other significant environmental impacts included ozone depletion, smog, acidification, and eutrophication.</p><p><strong>Discussion: </strong>Reducing energy consumption by decarbonizing electricity sources and optimizing equipment use can significantly decrease greenhouse gas emissions. Implementing sustainable practices in linen use, procurement, and end-of-life management is also crucial. Reducing low-value imaging can further mitigate environmental impact.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Iodine Opportunity for Sustainable Radiology: Quantifying Supply Chain Strategies to Cut Contrast's Carbon and Costs.","authors":"Derrik X Nghiem, Noushin Yahyavi-Firouz-Abadi, Gloria L Hwang, Zafar Zafari, Linda Moy, Ruth C Carlos, Florence X Doo","doi":"10.1016/j.jacr.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.027","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate economic and environmental reduction potential of iodinated contrast media (ICM) saving strategies, by examining supply chain data (from iodine extraction through administration) to inform a decision-making framework which can be tailored to local institutional priorities.</p><p><strong>Methods: </strong>A 100 mL polymer vial of ICM was set as the standard reference case (SRC) for baseline comparison. To evaluate cost and emissions impacts, four ICM reduction strategies were modeled relative to this SRC baseline: vial optimization, hardware or software (AI-enabled) dose reduction, and multi-dose vial/injector systems. This analysis was then translated into a decision-making framework for radiologists to compare ICM strategies by cost, emissions, and operational feasibility.</p><p><strong>Results: </strong>The supply chain life cycle of a 100 mL iodinated contrast vial produces 1,029 g CO2e, primarily from iodine extraction and clinical use. ICM-saving strategies varied widely in emissions reduction, ranging from 12%-50% nationally. Economically a 125% tariff could inflate national ICM-related costs to $11.9B, the ICM reduction strategy of AI-enhanced ICM systems could lower this expenditure to $2.7B. Institutional analysis reveals that the ICM savings from high-capital upfront investment strategies can offset their initial investment, highlighting important trade-offs for implementation decision-making.</p><p><strong>Conclusion: </strong>ICM is a major and modifiable contributor to healthcare carbon emissions. Depending on the utilized ICM-reduction strategy, emissions can be reduced by up to 53% and ICM-related costs by up to 50%. To guide implementation, we developed a decision-making framework that categorizes strategies based on environmental benefit, cost, and operational feasibility, enabling radiology leaders to align sustainability goals with institutional priorities.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenges and Promises of Artificial Intelligence Triage Systems in Practice.","authors":"Sarah J Ricklan, Tessa S Cook","doi":"10.1016/j.jacr.2025.08.026","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.08.026","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Leadership in Quiet Quitting.","authors":"Elliot K Fishman, Steven P Rowe, Connor W Smith","doi":"10.1016/j.jacr.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.026","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Funding and incentives for resident education in an era of radiologist shortages, increasing workload, and financial constraints.","authors":"Elaine Flynn, Ryan Tai, George J Watts V, Max P Rosen","doi":"10.1016/j.jacr.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.023","url":null,"abstract":"<p><p>Training the next generation of radiologists is essential given the ongoing national radiologist shortage. However, funding residency positions and incentivizing high-quality resident education remains a challenge. Increasing demand for imaging leading to increased radiologist workloads and moonlighting, the rise of remote work, and the use of productivity measures that value clinical work over time spent on resident education may create barriers to high-quality resident education. This paper outlines graduate medical education (GME) funding sources, the direct and indirect costs of training radiology residents, resident contributions to their departments, and the support needed to facilitate academic faculty to deliver high-quality resident education. Incorporating teaching activities into productivity measures, offering a clinician-educator path to promotion, supporting professional development, and recognizing excellence in teaching can help incentivize a focus on resident education. Additionally, diversifying clinical work with educational activities and appropriately compensating faculty may help increase faculty's enthusiasm for resident education, promote job satisfaction, and improve morale.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Academic Mission Starts, or Ends, at the Top.","authors":"Elliot K Fishman, Daniel J Lee, Linda C Chu, Steven P Rowe","doi":"10.1016/j.jacr.2025.09.028","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.028","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologists' Perceptions of the 21^st Century Cures Act.","authors":"Jessica H Porembka, Emily L Paton, Yin Xi, Ruth C Carlos, Sheena Bhalla, Jeremy P Cetnar, Sukh Makhnoon, Arun Krishnaraj, Eric M Rubin, David E Gerber","doi":"10.1016/j.jacr.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.09.025","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}