It is November again, and many of us will soon be heading to Chicago for RSNA. This year’s RSNA theme, “At the Center of Care,” reflects the evolving role of radiology and radiologists in care delivery. It also captures some of my hopes as I consider the future of our specialty: not at the margins of a patient’s journey, but increasingly at its center.
Imaging volumes are growing steadily, with no sign of slowing. A recent JACR study found a 31% increase in examinations read at participating facilities between the first quarters of 2018 and 2024, an average annual growth rate of 4.6%.1
As radiologists, we often discuss this growth in terms of staffing, worklists, turnaround times, and productivity. Those pressures are real. But the volumes also tell us something important about how the practice of medicine is changing and our place in the future of clinical care. In a world that relies increasingly on imaging for clinical decision-making, I believe that we have an opportunity, and an obligation, to play a more central role in patient care.
Traditionally, the radiologist’s job has been to answer a clinical question. A patient develops a symptom, a clinician orders an examination, and we help explain what is wrong. That component of our work remains essential.
Increasingly, however, we enter the care pathway earlier, identifying risks and findings before anyone knows to ask about them. A CT performed for abdominal pain may reveal low bone density and lead to lifestyle changes or medication to reduce fracture risk. Coronary artery calcification on a chest CT or breast arterial calcification on a mammogram may be a patient’s first sign of cardiovascular risk. These findings can open the door to prevention, even when they have little to do with the reason the examination was ordered. In such cases, imaging becomes more than an answer to a question; it becomes the starting point for a new conversation and a new care pathway.
Across the many examinations we interpret, these opportunities give radiology a growing role in population health. We can help identify patients who may benefit from further evaluation, surveillance, or preventive care.
To truly realize our potential, we will need to rethink our responsibilities. As our role shifts toward risk identification and early disease detection, our value cannot be defined by making an accurate diagnosis and issuing a report. Instead, it will be measured by whether our findings are understood, communicated, and translated into the right care. That does not mean radiologists must manage every subsequent step, but it does mean we should help create dependable pathways.
Consumer-driven imaging introduces another change to our place in care delivery. This issue’s discussion of whole-body MRI explores patients’ growing interest in understanding their health before symptoms develop. Some come to us without a specific clinical question, hoping imaging will reveal whether there is anything they should know. These encounters will change the relationship between radiologists and patients, making us visible clinical partners rather than unseen interpreters.
Rising imaging volumes and new care models present real challenges, but they also create an extraordinary opportunity for our specialty. If we respond only by reading faster, we may miss the larger transformation taking place. If, rather, we commit to clearer communication, stronger follow-up systems, and closer collaboration with patients and clinical colleagues, we can help shape care well beyond the reading room. By accepting that challenge, radiology and radiologists can truly be at the center of care.
