EPISODE · S1 E9 · Jun 25, 2025 · 10 MIN

Episode 9

AI mandates, pay cuts, and 90 minutes of daily paperwork — the squeeze is real.

Transcript

Hey there, welcome to "Beyond the Scan"! I'm Jackie, your host, and I'm so glad you're joining me today, Wednesday, June 25, 2025.

Quick shoutout to our sponsor RadiologyJobs.com—they're doing amazing work connecting imaging professionals with great opportunities nationwide.

I've got some really exciting stories to share with you today!

So, let me jump right in with something that honestly gave me chills when I first read about it. The FDA just granted what's called "De Novo clearance" to this incredible AI platform called IncidentalGuard AI, and folks... this is a game-changer.

Now, let me explain what this means in simple terms. You know how sometimes when you get a CT scan of your chest for one thing—maybe checking for pneumonia—the scan might also show something completely unexpected? Like a suspicious spot on your lung that nobody was looking for originally? Well, these are called "incidental findings," and honestly, they can be life-saving discoveries... but only if someone catches them.

That's where IncidentalGuard AI comes in. This software is like having a really, really vigilant extra set of eyes looking at every chest CT scan. It automatically flags things like aortic aneurysms—those are dangerous bulges in your main artery—pulmonary emboli, which are blood clots in the lungs, and suspicious lung nodules that might need follow-up.

The numbers here are just... they're impressive. In testing with over 10,000 scans, this AI caught 94% of these critical findings with 97% accuracy. That means it's not crying wolf all the time, but it's also not missing the important stuff.

For radiologists, this is like having a safety net that never gets tired, never has a bad day, and never gets distracted. And let's be honest—we're all human, right? Sometimes things get missed, especially when you're reading hundreds of scans a day. This technology could literally save lives by making sure nothing slips through the cracks.

But here's what I find fascinating about this FDA approval—it's actually creating a whole new category of medical devices. This "De Novo clearance" means the FDA is essentially saying, "This is so innovative, we need new rules for it." That tells us we're looking at the future of radiology right here.

Now, speaking of the future... and this next story is a bit more sobering. CMS—that's the Centers for Medicare & Medicaid Services—just dropped their proposed 2026 fee schedule, and... well, let's just say it's causing quite a stir in our community.

They're proposing an average 4.5% cut in reimbursements for CT and MRI scans in hospital outpatient departments. Now, I know that might sound like inside baseball to some of you, but here's why this matters for everyone: when reimbursements get cut, it puts pressure on imaging centers and hospitals. That can mean longer wait times, older equipment, or fewer locations offering services.

But here's the really interesting part—and honestly, I'm not sure if it's brilliant or concerning. CMS wants to tie some of your facility's payments to whether they're using "certified AI-driven appropriate use criteria." Basically, they want AI systems to help doctors decide when you really need that MRI versus when maybe a different test would be better.

On one hand, this could reduce unnecessary scans and save the healthcare system money. On the other hand... the American College of Radiology is pretty fired up about this, calling it "unsustainable" and warning that it's putting the cart before the horse—forcing people to invest in AI before we really know how well it works in the real world.

I... I have to say, this feels like we're at this fascinating crossroads where technology, economics, and patient care are all colliding. It's exciting and a little nerve-wracking at the same time.

Alright, let me shift gears to something that's been on my mind for years—and I know many of you have worried about this too. It's about gadolinium, that contrast agent we use in MRI scans to make certain things show up more clearly.

For almost a decade now, there's been this lingering concern about whether gadolinium stays in your brain after MRI scans. And look, as someone who's had multiple contrast MRIs myself, this has been... it's been something I've personally wondered about during those long nights when your mind starts racing, you know?

Well, we just got some fantastic news. The SECURE-MR trial results were published in The New England Journal of Medicine—and that's like the gold standard of medical journals—showing that a new type of gadolinium contrast agent called gadoterate meglumine+ shows basically zero brain retention over five years.

This study followed over 800 patients who needed multiple contrast MRIs—people with cancer or multiple sclerosis who were getting scanned regularly. And the results? The new agent provided just as good image quality as what we're using now, but without that nagging worry about buildup in the brain.

For anyone out there who's been putting off needed MRI scans because of these concerns, or for patients with chronic conditions who need regular monitoring... this could be huge. It's like finally getting that peace of mind we've all been waiting for.

I have to tell you, when I read this study, I actually got a little emotional. Because I think about all the patients over the years who've asked me, "Is it safe? Should I be worried?" And now we might finally have an answer that lets everyone sleep a little better at night.

Now, I need to talk about something that hits really close to home for all of us in radiology, and honestly, it's something that's been weighing on my heart lately. The ACR just released their 2025 Workforce Survey, and... the results are pretty sobering.

Sixty-eight percent of radiologists are reporting burnout symptoms. That's up twelve points from just three years ago. And while you might think it's because we're reading more scans than ever—which we are—that's not actually the main culprit here.

The real problem? Radiologists are now spending an average of 90 minutes every day on stuff that has nothing to do with actually reading your scans. We're talking about EMR documentation—that's electronic medical records—dealing with multiple messaging apps, getting insurance authorizations... basically, a lot of administrative busywork.

Dr. Eva Jimenez from the ACR put it perfectly when she said we're asking our most highly trained imaging experts to function as data-entry clerks and schedulers. And you know what? She's absolutely right.

Think about it this way—when you go to see a radiologist, you want them focused on your images, using all that training and expertise to catch things that matter for your health. You don't want them distracted by insurance paperwork or struggling with clunky computer systems.

This really hits me personally because I've seen how passionate radiologists are about patient care. They went through years of training to become experts at seeing things others might miss. But when they're spending more time fighting with computer systems than actually using their skills... that's when people start questioning whether it's all worth it.

The good news is that some places are trying something called "focused reading sessions," where radiologists are completely shielded from interruptions so they can just... read. Just do what they do best. And early results suggest this is helping with both job satisfaction and diagnostic accuracy.

But we need healthcare systems to step up here. Better IT integration, dedicated support staff, streamlined communication—these aren't luxuries, they're necessities if we want to keep talented radiologists in the field and make sure patients get the best possible care.

You know what strikes me about all these stories today? They're all connected by this common thread of how technology can either help us or... well, make our lives more complicated. We've got AI that can catch life-threatening findings we might miss, but we also have electronic systems that are burning people out. We have safer contrast agents, but payment systems that are pushing practices to adopt AI before we fully understand it.

It really makes me think about how important it is that we—as a profession, as a healthcare system—stay focused on what matters most: taking the best possible care of patients while also taking care of the people who dedicate their careers to this work.

Because at the end of the day, behind every scan, every diagnosis, every technological advancement, there are real people. Patients who are worried about their health, and healthcare professionals who chose this field because they want to make a difference.

Well, that's all we have for today's episode of "Beyond the Scan." I've really enjoyed sharing these developments with you.

If you found today's discussion helpful, I'd love it if you'd subscribe and share with your colleagues. And hey, swing by our website at beyondthescan.com where we've got some great additional resources on these topics.

I'll be back next week with more exciting updates. This is Jackie signing off, and remember—what we do really does make a difference in people's lives every day. Take care!