Ionizing Radiation Exposure: What are the Risks Today?

Medical imaging plays an increasingly central role in the diagnostic workup and management of patients. As imaging technologies evolve, the radiology community faces the challenge of balancing the diagnostic benefits of medical imaging with the potential risks associated with ionizing radiation. As part of the Association of Academic Radiology's 2025 Radiology Research Alliance task force, we present an updated review of the current literature on the risks associated with ionizing radiation in medical imaging, discuss technological advances focused on dose reduction, and present best practices for safety protocols.

Vulnerable Patient Intensified Protocol to Reduce Readmission Disparities After Coronary Artery Bypass Grafting: Design, Implementation, and Lessons Learned from a Quality Initiative.

Goal: In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced equity metrics for healthcare systems to document social determinants of health (SDOH). Payment determinations were also linked to readmission performance measures. Readmission prevention programs for vulnerable patients, defined by CMS as dually eligible (DE) for Medicare and Medicaid, racial/ethnic minorities, and those with disabling conditions, have the potential to reduce readmission disparities.

Nerve-associated macrophages control adipose homeostasis across lifespan and restrain age-related inflammation.

Age-related inflammation or 'inflammaging' increases disease burden and controls lifespan. Adipose tissue macrophages (ATMs) are critical regulators of inflammaging; however, the mechanisms involved are not well understood in part because the molecular identities of niche-specific ATMs are unknown. Using intravascular labeling to exclude circulating myeloid cells followed by single-cell sequencing with orthogonal validation via multiparametric flow cytometry, we define sex-specific changes and diverse populations of resident ATMs through lifespan in mice.

Waste Audit of Robotic Gynecologic Surgery: A Pilot Study.

Study Objective: To quantify and characterize waste generated in robotic gynecologic surgery and assess its environmental impact, with the goal of identifying strategies to reduce waste and improve sustainability.

Design: Waste audit and life cycle impact assessment of robotic gynecologic surgery.

Setting: Single academic institution.

Trends in Thumb Carpometacarpal Arthroplasty: A Decade in Review.

Background: Carpometacarpal (CMC) arthroplasty can provide symptomatic relief and improvement in function in patients with CMC osteoarthritis. The study purpose was to identify demographic, 30-day outcome, and reimbursement trends in CMC arthroplasty between 2012 and 2021.

Methods: This was a retrospective cohort study of adult patients undergoing CMC arthroplasty from January 1, 2012, to December 31, 2021, using the National Surgical Quality Improvement Program database.

Breast Imaging Staffing Shortages: Defining the Problem and Addressing Root Causes.

Objective: To assess the current perceptions of breast imaging staffing shortages and contributing factors among breast imaging radiologists.

Methods: A survey assessing current perception of breast radiologists regarding breast imaging-specific staffing shortages and contributing factors was developed by the Patient Care and Delivery Committee of the Society of Breast Imaging (SBI) and emailed to SBI active physician members. Bivariable analysis (chi-squared, t test) was performed between the survey demographics and survey response questions of interest.

Establishment of standardized definitions and a core set of outcome characteristics following hidradenitis suppurativa surgery developed by an expert Delphi consensus.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition often requiring surgical intervention for definitive treatment. Previous studies evaluated post-surgical outcomes, but no standardization exists for collection and nomenclature for HS surgical outcomes.

Objective: To characterize and define surgical outcome terminology.

Poly-4-Hydroxybutyrate as a Novel Biomaterial in Personalized Breast Surgery: A Systematic Review and Meta-Analysis.

: In the search for optimal meshes and matrices in breast surgery, poly-4-hydroxybutyrate (P4HB) has emerged as a promising alternative. This review evaluates the clinical application of P4HB scaffolds, focusing on complication rates and surgical outcomes. : A systematic search was conducted using PubMed and ScienceDirect.

Analysis of the Distribution of Private Research Funding to Sports Medicine Orthopaedic Surgeons.

Background: The Physician Payments Sunshine Act mandated the public reporting of all industry payments above a $10 value that are disbursed to physicians in the United States. Understanding the pattern of research payments among sports medicine orthopaedic surgeons (SMOSs) may help uncover potential biases and conflicts of interest, thereby promoting transparency and ethical conduct in musculoskeletal research.

Purpose: To identify trends in private research payment distribution among SMOSs and to explore potential sources of disparity in the disbursement of research-related private funding.

Adjunctive Imaging and Physiology During PCI Among Black and White Medicare Beneficiaries: Disparities in Utilization Patterns and Outcomes.

Background: Racial differences in the use and outcomes of intravascular imaging (IVI) and invasive physiology (IP) during percutaneous coronary intervention (PCI) are underreported in the United States.

Methods: Medicare fee-for-service claims data were used to examine the use and outcomes of IVI- and IP-guided PCI by Black versus White race (2016-2023). Multivariable logistic regression was used to assess the association between race and IVI/IP use.

Evaluating Large Language Models for Radiology Systematic Review Title and Abstract Screening.

Rationale And Objectives: To evaluate the performance, stability, and decision-making behavior of large language models (LLMs) for title and abstract screening for radiology systematic reviews, with attention to prompt framing, confidence calibration, and model robustness under disagreement.

Materials And Methods: We compared five LLMs (GPT-4o, GPT-4o mini, Gemini 1.5 Pro, Gemini 2.

Medial Osteochondral Defect Drives Matrix and Cell Pathology in Compartment-Matched Meniscus.

Patients with cartilage defects often experience increased meniscal degeneration. It remains unclear whether meniscal damage occurs concurrently with cartilage injury or due to later joint pathology. Limited data exists on how isolated cartilage injuries affect meniscal structure and degeneration.

Risk of malnutrition increases in the year prior to surgery among patients with inflammatory bowel disease.

Background: In patients with inflammatory bowel disease (IBD) who need intestinal resection, prior data suggest that earlier surgical intervention may be associated with improved outcomes. However, surgery is often deferred for additional trials of advanced therapies, which potentially shifts patients from a fit to a frail preoperative state.

Objectives: This study aimed to evaluate clinical changes that occur in the year prior to intestinal resection in patients with IBD.

Region-specific gene expression and sex inform about disease susceptibility in the aorta.

Pathology in large vessels frequently develops at specific locations, implying that local stressors and spatially restricted gene expression are likely contributors to disease susceptibility. Here we perform single-cell transcriptomics in the carotids, the aortic arch and the thoracic and abdominal aorta to identify site- and sex-specific differences that could inform about vulnerability. Our findings revealed (1) regionally defined transcriptional profiles, (2) signatures associated with embryonic origins and (3) differential contributions of sex-specific effectors.

Ischemic Injury Drives Nascent Tumor Growth Via Accelerated Hematopoietic Aging.

Background: Patients with peripheral artery disease have an increased risk of cancer development. Aging-associated changes in hematopoietic stem and progenitor cells (HSPCs), including inflammation and increased myelopoiesis, are implicated in both cardiovascular disease and cancer, but their contributions to cardiovascular disease-driven tumor progression are unclear.

Objectives: This study sought to study tumor growth after peripheral ischemia and consequent changes within the HSPC bone marrow compartment to uncover mechanisms through which altered hematopoiesis promotes cancer.

Comparative Risk of Infection and Prevalence of Combination Targeted Therapy in Psoriatic Arthritis.

Importance: Achieving good disease control in psoriatic arthritis (PsA) remains a major challenge. Combining multiple systemic immunomodulatory therapies has been shown to be beneficial in other immune-mediated diseases with reasonable safety profiles, but data on the current use and safety of combination targeted therapy among individuals with PsA are limited.

Objective: To evaluate the use and safety of combination targeted therapies among adults with PsA.

Targeting FSP1 triggers ferroptosis in lung cancer.

Pre-clinical and clinical studies have demonstrated how dietary antioxidants or mutations activating antioxidant metabolism promote cancer, highlighting a central role oxidative stress in tumorigenesis. However, it is unclear if oxidative stress ultimately increases to a point of cell death. Emerging evidence indicates that cancer cells are susceptible to ferroptosis, a form of cell death triggered by uncontrolled lipid peroxidation.

Paired plus-minus sequencing is an ultra-high throughput and accurate method for dual strand sequencing of DNA molecules.

Distinguishing real biological variation in the form of single-nucleotide variants (SNVs) from errors is a major challenge for genome sequencing technologies. This is particularly true in settings where SNVs are at low frequency such as cancer detection through liquid biopsy, or human somatic mosaicism. State-of-the-art molecular denoising approaches for DNA sequencing rely on duplex sequencing, where both strands of a single DNA molecule are sequenced to discern true variants from errors arising from single stranded DNA damage.

VI-RADS quality score: development and proposal of a scoring system by the American College of Radiology VI-RADS Steering Committee.

High-quality bladder MRI is essential for reliable detection and characterization of bladder tumors. While the Vesical Imaging Reporting and Data System (VI-RADS) was developed to standardize acquisition, interpretation, and reporting of MRI for bladder cancer staging, no universal scoring system has been established for quality assessment. A systematic review showed that existing efforts for bladder MRI quality assessment have largely relied on study-specific, subjective Likert-type scales, with substantial variability, hindering reproducibility and comparability across studies and institutions.

Placental epigenetic clocks derived from crowdsourcing: Implications for the study of accelerated aging in obstetrics.

Epigenetic gestational age acceleration has been implicated in obstetric syndromes including preeclampsia, yet robust conclusions require accurate and unbiased epigenetic age models. Herein, we curated 1,842 public placental methylomes and organized a DREAM challenge to develop models of gestational age. Participants were blinded to the test data that we generated from 384 placentas encompassing normal and complicated pregnancies.

Evaluation of the combination lenvatinib and pembrolizumab in endometrial cancer; a real world multi-institutional review of practice patterns, efficacy and tolerability.

Objective: KEYNOTE-775 defined lenvatinib/pembrolizumab as the new standard-of-care for patients with proficient mismatch repair (pMMR) recurrent EC. However, the regimen required dose reductions in 66.5 % of participants and the generalizability of these results was uncertain.

The impact of perioperative chemotherapy in patients with pancreatic adenosquamous carcinoma.

Background: Pancreatic adenosquamous carcinoma has historically poor overall survival, and the impact of perioperative chemotherapy remains unclear. We aimed to evaluate the impact of various chemotherapy regimens in patients with resected adenosquamous carcinoma.

Methods: Patients with resected adenosquamous carcinoma were identified from 3 high-volume programs between 2001 and 2022.

Cost-Effectiveness of Endoscopic Stricturotomy Versus Resection Surgery for Crohn's Disease Strictures.

Endoscopic therapies for Crohn's disease (CD) strictures, including endoscopic balloon dilation (EBD) and endoscopic stricturotomy (ESt), are less invasive interventions compared to surgery. ESt is advantageous for strictures that are longer, more fibrotic, or adjacent to anatomic structures requiring precision, and it has shown a high rate of surgery-free survival. We designed a microsimulation state-transition model comparing ESt to surgical resection for CD strictures.

Outcomes of Abdominal Contouring in Patients With and Without Weight Loss Surgery: A Propensity-Matched Comparison Study.

Background: Patients undergo abdominoplasty/panniculectomy following excessive weight loss and/or to improve abdominal appearance/shape. The authors aim to compare clinical outcomes and quality of life (QoL) following these procedures in patients with/without a history of weight loss surgery (WLS).

Methods: A single-center, single-surgeon retrospective review from 2015-2022 was performed examining patients who underwent abdominal contouring procedures with/without a history of WLS.