Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.11.006
Vir Gogoi , Sharon L. D’Souza MD, MPH
{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass","authors":"Vir Gogoi , Sharon L. D’Souza MD, MPH","doi":"10.1016/j.jacr.2025.11.006","DOIUrl":"10.1016/j.jacr.2025.11.006","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Page 340"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.11.023
Yunus Yasar MD , Mustafa Demir MD , Ahmet Harun Turgan MD , Ali Cantürk MD
{"title":"GPT-4o in Interventional Radiology Decision-Making: A Simulation Study Using ACR Appropriateness Criteria","authors":"Yunus Yasar MD , Mustafa Demir MD , Ahmet Harun Turgan MD , Ali Cantürk MD","doi":"10.1016/j.jacr.2025.11.023","DOIUrl":"10.1016/j.jacr.2025.11.023","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Pages 299-302"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.12.003
Akongnwi Jungong Cheo MD , Danika Baskar MD , Stephen Dwumfour , Ryan B. Peterson MD , Amit M. Saindane MD, MBA , Mark E. Mullins MD, PhD
Radiology medical education in the United States continues to face complex economic challenges. Training programs in this field are expanding at an insufficient rate relative to demand. Despite decades-old federal caps on radiology training positions, Medicare continues to be the largest provider of graduate medical education funding by a wide margin. The recent increase in radiology case volume is contributing to burnout and aggravating the pressures on academic radiology programs, further increasing the need for a larger and well-trained radiology workforce. Understanding the current radiology education funding structure is paramount for crafting potential solutions. Diversifying funding approaches, bolstering traditional funding sources, and developing new funding mechanisms for radiology education will enhance the pipeline for practicing radiologists. This review provides a summary of current radiology education funding, the impact of Medicare training positions caps on graduate medical education, and the impact of recent federal health care spending cuts on radiology training and proposes strategies to increase the number of radiology residency graduates.
{"title":"The Economics of Radiology Education in the United States: Challenges and Opportunities","authors":"Akongnwi Jungong Cheo MD , Danika Baskar MD , Stephen Dwumfour , Ryan B. Peterson MD , Amit M. Saindane MD, MBA , Mark E. Mullins MD, PhD","doi":"10.1016/j.jacr.2025.12.003","DOIUrl":"10.1016/j.jacr.2025.12.003","url":null,"abstract":"<div><div>Radiology medical education in the United States continues to face complex economic challenges. Training programs in this field are expanding at an insufficient rate relative to demand. Despite decades-old federal caps on radiology training positions, Medicare continues to be the largest provider of graduate medical education funding by a wide margin. The recent increase in radiology case volume is contributing to burnout and aggravating the pressures on academic radiology programs, further increasing the need for a larger and well-trained radiology workforce. Understanding the current radiology education funding structure is paramount for crafting potential solutions. Diversifying funding approaches, bolstering traditional funding sources, and developing new funding mechanisms for radiology education will enhance the pipeline for practicing radiologists. This review provides a summary of current radiology education funding, the impact of Medicare training positions caps on graduate medical education, and the impact of recent federal health care spending cuts on radiology training and proposes strategies to increase the number of radiology residency graduates.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Pages 183-191"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.06.032
Kimberly Powell MS , Elliot K. Fishman MD , Linda C. Chu MD , Steven P. Rowe MD, PhD , Charles K. Crawford BS
{"title":"Agentic Artificial Intelligence: The Power to Change Medicine and Our World","authors":"Kimberly Powell MS , Elliot K. Fishman MD , Linda C. Chu MD , Steven P. Rowe MD, PhD , Charles K. Crawford BS","doi":"10.1016/j.jacr.2025.06.032","DOIUrl":"10.1016/j.jacr.2025.06.032","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Pages 306-308"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.11.021
Corey Feuer BA , Gregory J. Czuczman MD
{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Cervical Pain or Cervical Radiculopathy: 2025 Update","authors":"Corey Feuer BA , Gregory J. Czuczman MD","doi":"10.1016/j.jacr.2025.11.021","DOIUrl":"10.1016/j.jacr.2025.11.021","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Page 331"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.11.022
Maya Doyle BA , Sonya Bhole MD
{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: First Trimester Vaginal Bleeding: 2025 Update","authors":"Maya Doyle BA , Sonya Bhole MD","doi":"10.1016/j.jacr.2025.11.022","DOIUrl":"10.1016/j.jacr.2025.11.022","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Page 330"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.12.022
Fatima Elahi DO, MHA , Tara M. Catanzano MD
{"title":"Introduction to the Focus Issue on the Economics of Education","authors":"Fatima Elahi DO, MHA , Tara M. Catanzano MD","doi":"10.1016/j.jacr.2025.12.022","DOIUrl":"10.1016/j.jacr.2025.12.022","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Pages 181-182"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.08.012
Jack Smith , Elliot K. Fishman MD , Steven P. Rowe MD, PhD , Linda C. Chu MD , Charles K. Crawford BS
{"title":"Can Obsolescence Be Cured?","authors":"Jack Smith , Elliot K. Fishman MD , Steven P. Rowe MD, PhD , Linda C. Chu MD , Charles K. Crawford BS","doi":"10.1016/j.jacr.2025.08.012","DOIUrl":"10.1016/j.jacr.2025.08.012","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Pages 324-326"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.09.018
Stella K. Kang MD, MSc , Jenny Hoang MBBS, MHS, MBA , Tarik Alkasab MD, PhD , Jacqueline A. Bello MD , Lincoln Berland MD , Jay Bronner MD , Mythreyi Chatfield PhD , David Kurth MA, MPH , Etta Pisano MD , James V. Rawson MD , David Seidenwurm MD , Jeffrey Weinreb MD , Hanna M. Zafar MD, MHS , Pari V. Pandharipande MD, MPH
We summarize a new process for developing algorithm-based recommendations for the ACR. This process is currently applied to the ACR’s incidental findings recommendations, and other committees providing evidence-based recommendations may elect to adopt these processes in the future. The prior process relied upon informal consensus and was versatile but more limited in scalability and generalizability. Most importantly, the absence of a formal, evidence-driven process prevented incidental findings and other algorithms from receiving designation as clinical guidelines per the National Academy of Medicine’s Trustworthy Guidelines criteria and limited both referrer and policymaker adoption. In response, a committee of key stakeholders was formed with approval of the ACR to develop a new process that would overcome these drawbacks, including members from the ACR’s Incidental Findings and Reporting and Data Systems committees, the ACR’s Commissions on Quality and Safety and Informatics, academic and private practice settings, as well as ACR staff. Here we present the formal, evidence-driven process for algorithm-based imaging recommendations developed by this committee. This process is generalizable to committees across the ACR.
{"title":"Developing Algorithm-Based Recommendations in the ACR: Defining a New Process","authors":"Stella K. Kang MD, MSc , Jenny Hoang MBBS, MHS, MBA , Tarik Alkasab MD, PhD , Jacqueline A. Bello MD , Lincoln Berland MD , Jay Bronner MD , Mythreyi Chatfield PhD , David Kurth MA, MPH , Etta Pisano MD , James V. Rawson MD , David Seidenwurm MD , Jeffrey Weinreb MD , Hanna M. Zafar MD, MHS , Pari V. Pandharipande MD, MPH","doi":"10.1016/j.jacr.2025.09.018","DOIUrl":"10.1016/j.jacr.2025.09.018","url":null,"abstract":"<div><div>We summarize a new process for developing algorithm-based recommendations for the ACR. This process is currently applied to the ACR’s incidental findings recommendations, and other committees providing evidence-based recommendations may elect to adopt these processes in the future. The prior process relied upon informal consensus and was versatile but more limited in scalability and generalizability. Most importantly, the absence of a formal, evidence-driven process prevented incidental findings and other algorithms from receiving designation as clinical guidelines per the National Academy of Medicine’s Trustworthy Guidelines criteria and limited both referrer and policymaker adoption. In response, a committee of key stakeholders was formed with approval of the ACR to develop a new process that would overcome these drawbacks, including members from the ACR’s Incidental Findings and Reporting and Data Systems committees, the ACR’s Commissions on Quality and Safety and Informatics, academic and private practice settings, as well as ACR staff. Here we present the formal, evidence-driven process for algorithm-based imaging recommendations developed by this committee. This process is generalizable to committees across the ACR.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Pages 312-317"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jacr.2025.11.014
Lily Kwak BA , Saloni Patel BS , Gayane Yenokyan MD, MHS, PhD , Gelareh Sadigh MD , Randy C. Miles MD, MPH , Elizabeth S. McDonald MD, PhD , Eniola T. Oluyemi MD, MPH , Ruth C. Carlos MD, MS
Objective
Allostatic load (AL) is a measure of physiologic dysregulation representing the cumulative effect of activation of the stress response system. The purpose of this study was to evaluate the association between AL and malignant pathology on image-guided breast biopsy.
Methods
This retrospective cohort study evaluated data from women aged 18 and older who underwent stereotactic-guided or ultrasound-guided breast biopsy at our tertiary academic institution from April 1, 2017, to March 31, 2022. We recorded patient age, race, ethnicity, Gail Model breast cancer risk score, area deprivation index, as well as AL calculated using clinical laboratory metrics from four major physiological systems—cardiovascular, immune, metabolic, and renal. The primary outcome was malignant pathology, and the secondary outcome was high-risk pathology. The association between AL and pathology result was evaluated using multivariable logistic regressions.
Results
In all, 253 patients were included in the study with mean age of 61 years (SD 12). After adjustment for age, race, ethnicity, and area deprivation index, higher AL was associated with a 22% increase in odds of malignant breast pathology (odds ratio [OR] 1.22 per additional biomarker positivity, 95% confidence interval [CI] 1.03-1.44). The association remained positive but was no longer significant after further adjustment for the Gail 5-year risk score (OR 1.17, 95% CI 0.93-1.47). Of note, 33.6% of patients had missing Gail risk score. No significant association of AL with high-risk pathology (OR 0.99, 95% CI 0.77-1.28) was observed.
Discussion
Our study results suggest that increased AL is associated with malignant pathology result in women undergoing image-guided core needle breast biopsy. This has implications for efforts to optimize personalized screening recommendations and reduce cancer disparities.
{"title":"Evaluating the Association Between Allostatic Load and Malignancy on Image-Guided Breast Biopsy","authors":"Lily Kwak BA , Saloni Patel BS , Gayane Yenokyan MD, MHS, PhD , Gelareh Sadigh MD , Randy C. Miles MD, MPH , Elizabeth S. McDonald MD, PhD , Eniola T. Oluyemi MD, MPH , Ruth C. Carlos MD, MS","doi":"10.1016/j.jacr.2025.11.014","DOIUrl":"10.1016/j.jacr.2025.11.014","url":null,"abstract":"<div><h3>Objective</h3><div>Allostatic load (AL) is a measure of physiologic dysregulation representing the cumulative effect of activation of the stress response system. The purpose of this study was to evaluate the association between AL and malignant pathology on image-guided breast biopsy.</div></div><div><h3>Methods</h3><div>This retrospective cohort study evaluated data from women aged 18 and older who underwent stereotactic-guided or ultrasound-guided breast biopsy at our tertiary academic institution from April 1, 2017, to March 31, 2022. We recorded patient age, race, ethnicity, Gail Model breast cancer risk score, area deprivation index, as well as AL calculated using clinical laboratory metrics from four major physiological systems—cardiovascular, immune, metabolic, and renal. The primary outcome was malignant pathology, and the secondary outcome was high-risk pathology. The association between AL and pathology result was evaluated using multivariable logistic regressions.</div></div><div><h3>Results</h3><div>In all, 253 patients were included in the study with mean age of 61 years (SD 12). After adjustment for age, race, ethnicity, and area deprivation index, higher AL was associated with a 22% increase in odds of malignant breast pathology (odds ratio [OR] 1.22 per additional biomarker positivity, 95% confidence interval [CI] 1.03-1.44). The association remained positive but was no longer significant after further adjustment for the Gail 5-year risk score (OR 1.17, 95% CI 0.93-1.47). Of note, 33.6% of patients had missing Gail risk score. No significant association of AL with high-risk pathology (OR 0.99, 95% CI 0.77-1.28) was observed.</div></div><div><h3>Discussion</h3><div>Our study results suggest that increased AL is associated with malignant pathology result in women undergoing image-guided core needle breast biopsy. This has implications for efforts to optimize personalized screening recommendations and reduce cancer disparities.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 2","pages":"Pages 246-255"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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