Issuu

OCTOBER 2026 | VOLUME 10 | ISSUE 10

THEICECOMMUNITY.COM

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

COVER STORY

EXPANDING

REACH IN WOMEN’S IMAGING:

Mobile Care, Telehealth & Cultural Competencies PAGE 30

CT FO

C US

Women’s Imaging PAGE 27

NEW COURSES NOW AVAILABLE Philips Azurion Siemens Artis Q & Zee Siemens Force CT Siemens Revelation 3D Tomo GE Pristina 3D Tomo GE 450W MRI Family Explore our 60+ training courses at https://rsti-training.com

AWARDS In December 2026, we will announce the eight imaging directors or managers selected by our ICE audience for their outstanding contributions.

2026

SEE THE WINNERS IN THE DECEMBER ISSUE! New England Mideast Great Lakes Plains

Southeast Southwest Rocky Mountains Far West

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FEATURES

RISING STAR

Wellspan Chambersburg Hospital X-Ray Operations Manager Nikki Smith, ARRT (R)(CT), began her career after her education at Pennsylvania College of Technology with a focus in radiology.

30 COVER STORY

Telemammography, mobile imaging trailers and new technology can improve women’s imaging in the United States.

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ICEMAGAZINE | OCTOBER 2026

DIRECTOR’S CUT

Stop the bystander effect before it ruins your department.

ADVANCING THE IMAGING PROFESSIONAL

OCTOBER 2026

17 IMAGING NEWS

Catch up on the latest news from around the diagnostic imaging world.

28 PRODUCT FOCUS

Advances in 3D mammography, artificial intelligence and breast imaging technologies are impacting women’s imaging.

44 THEICECOMMUNITY.COM

EMOTIONAL INTELLIGENCE

When a technical expert is promoted to management, they’re at a new level in the organization.

ICEMAGAZINE

CONTENTS MD Publishing 1155 Senoia Rd, Ste. 200, Tyrone, GA 30290 Phone: 800-906-3373 President

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Vice President of Business Development Jayme McKelvey jayme@mdpublishing.com

Director of Client Services Megan Cabot megan@mdpublishing.com

Senior Account Executive Warren Kaufman warren@mdpublishing.com

Editor

John Wallace

Editorial Board

Beth Allen David V. Buczkowski Kimberly Love Megan M. Parker Dean Skillicorn Jason Theadore

Art Department Karlee Gower Taylor Hayes Alicia Brown

SPOTLIGHT

Rising Star Nikki Smith, ARRT (R)(CT), X-Ray Operations Manager at Wellspan Chambersburg Hospital

In Focus Amy Rutledge, MBA, CRA, RDMS

Off the Clock Kathryn Foland, RT(R), Witham Health Services of Lebanon, Indiana

ICE Debut ASG Superconductors

NEWS

PRODUCTS

26 28

Market Report

Product Focus Women’s Imaging

INSIGHTS

Director’s Circle: Women’s Imaging

Events

21 36

Webinars

Director’s Cut The Bystander Effect at Work: When Everyone Sees It, but No One Steps In

Digital Department

RSTI Built on Experience. Focused on What’s Next. Keeping Pace with an Evolving Imaging Service Industry

Accounting

PACS/IT/AI Intelligent Diagnostic Chain: Reshaping Radiologist Workflow

Emotional Intelligence Managers: Stop Solving Every Problem

DEI Othering in the Workplace: What Imaging Managers Need to Recognize

Medicine for the Soul 9 Steps for a Lifetime of Heart-Healthy Eating

48 50

ICEDEX

Kristin Leavoy

Linda Hasluem

Cindy Galindo Kennedy Krieg Haley Harris

Diane Costea

ICE Magazine (Vol. 10, Issue #10) October 2026 is published by MD Publishing, 1155 Senoia Rd, Ste. 200, Tyrone, GA 30290. For subscription information visit www. theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2026

Imaging News A Look at What’s Changing in the Imaging Industry

ICEMAGAZINE | OCTOBER 2026

ASRT Advocacy Begins With the Patient

ICE Maker Preferred Vendors

One probe restored Countless lives touched

Elevate Patient Care Rely on Innovatus Imaging

Let's meet at MDExpo in Orlando, October 13-15 Booth 401

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SPOTLIGHT

RISING

STAR

NIKKI SMITH, ARRT (R)(CT), X-RAY OPERATIONS MANAGER AT WELLSPAN CHAMBERSBURG HOSPITAL

ellSpan Chambersburg Hospital X-Ray Operations Manager Nikki Smith, ARRT (R)(CT), began her career after her education at Pennsylvania College of Technology with a focus in radiology. ICE Magazine Editor John Wallace recently found out more about Nikki and her goals for the future. Q: WHERE DID YOU GROW UP? A: Born and raised in Center Valley, Pennsylvania, currently residing in Waynesboro, Pennsylvania. Q: WHERE DID YOU RECEIVE YOUR IMAGING TRAINING/EDUCATION? WHAT DEGREES/CERTIFICATIONS DO YOU HAVE? A: I am a graduate of Pennsylvania College of Technology, where I completed my clinical internship at Williamsport Regional Medical Center, now part of UPMC. Directly after graduation, I was hired into the CT department and received hospital-based training in computed tomography. I currently hold board certifications in both X-ray and CT. Additionally, I have gained clinical experience working in MRI and PET, although I do not hold formal certifications in those modalities.

Pennsylvania native Nikki Smith earned an imaging education in her home state. She now helps deliver quality healthcare to individuals in the Waynesboro area.

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Q: HOW DID YOU FIRST DECIDE TO START WORKING IN IMAGING? A: I wish I could say that I aspired to work in healthcare my entire life, but that would be a lie. I have always enjoyed customer service because, simply put, I enjoy being around people. I bartended for four years and loved the constant interaction, communication and opportunity to meet different people every day. Long story short, I eventually decided to pursue ultrasound because I enjoyed working with people and, of course, babies. However, just one week before classes were scheduled to begin, the program was discontinued due to low enrollment. With my original plan suddenly off the table, I decided on a whim to give X-ray a try. And, well … here we are. What started as a last-minute change of plans turned into a career I never expected but has continued to grow ever since. ADVANCING THE IMAGING PROFESSIONAL

Q: WHAT IS THE MOST REWARDING ASPECT OF YOUR JOB? A: I genuinely enjoy people, and I have always had a strong motherly instinct. This profession takes both of those qualities and combines them into one. I can care for people on some of their worst days, with the hope that I can make their experience a little easier and maybe even send them home with a smile. Even a brief five- or 10-minute conversation gives me the opportunity to learn something about a patient – where they come from, what they are going through, or simply what makes them who they are. It constantly reminds me of how different and individual every person truly is. No day in healthcare is ever the same, and neither is any patient. That is one of the things I value most about this profession. Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: My current position allows both my team and me to continuously evaluate and improve our daily workflows for the benefit of our staff and patients. We collaborate regularly to identify ways we can provide the best possible care for every patient who walks through our doors. In my leadership role, I can take those ideas, develop them into practical solutions, and work toward implementing meaningful changes. One of the most rewarding aspects of my position is that I not only get to focus on patient care, but I also get to care for the individuals providing that care. By supporting my team and creating a positive work environment, I believe we can ultimately create a better experience for everyone. Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: The imaging field is constantly evolving as technology continues to advance. The amount of information that can be obtained from a single scan, sequence or image is remarkable. In just a matter of moments, medical imaging can provide answers that guide treatment, confirm a diagnosis or completely change the course of someone’s life. Being part of a profession that continues to grow and has such a significant impact on patient care is both exciting and rewarding. Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: Prior to joining WellSpan, I helped manage the daily operations of a cancer center. In addition to overseeing the imaging department, I managed several other services and departments under the same roof. Some of the greatest growth in my career happened during my time there. While developing into the leader I am today, I was also discovering the type of healthcare professional I wanted to be. Cancer patients are some of the kindest and most resilient individuals I have ever had the privilege of caring for. They are facing something unimaginable, yet they often show such genuine interest in the people caring for them. I learned about their life stories, shared countless laughs with them and, in return, they learned about me and my family.

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The relationships went beyond simply completing an exam or providing a service. Personalized healthcare and individualized care happen every single day. That experience taught me that healthcare is just as much about human connection as it is about medicine. I will forever be grateful to the patients who trusted me to be part of their journey and for an experience that helped shape both the leader and healthcare professional I am today. Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS? A: I am currently pursuing my bachelor’s degree in healthcare administration with the goal of continuing to advance my career into a director-level position. Moving into this type of leadership role would allow me to become more involved in the bigger picture of healthcare and contribute to improvements on a much larger scale. I hope to use my clinical experience and leadership background to help improve workflows, support healthcare professionals and, ultimately, create better experiences for patients. As I continue to advance into new leadership roles, however, I hope to never completely step away from direct patient care. My interactions with patients are what initially shaped me as a healthcare professional and continue to remind me why the decisions we make as leaders matter. No matter where my career takes me, I want to maintain that connection to the patients and staff who are directly impacted by the decisions we make. •

FUN FACTS FAVORITE HOBBY: Anything outdoors, painting/drawing, and spending time with my family FAVORITE SHOW: Two small children, a full-time career and schooling don’t allow for much TV watching. I’ve seen a lot of PAW Patrol. FAVORITE FOOD: Mexican FAVORITE VACATION SPOT: The Outer Banks 1 THING ON YOUR BUCKET LIST: To travel around the U.S. and see the giant, man-made troll sculptures. SOMETHING YOUR CO-WORKERS DON’T KNOW ABOUT YOU: I come from a family of race car drivers, back in my prime; I even raced with them myself.

ICEMAGAZINE

SPOTLIGHT

IN FOCUS AMY RUTLEDGE, MBA, CRA, RDMS

deep desire to help others, along with a realization that she wanted to change her major during college, created a fulfilling career for Piedmont Macon and Macon North Hospitals Director of Imaging Services Amy Rutledge, MBA, CRA, RDMS. “I stumbled into radiology,” she explains. “I was enrolled in a social services program in college and nearing the end of the program was when I realized I did not feel fulfilled with that work. I knew I wanted to help people but wasn’t sure how. I wandered into a career fair and spoke with a sonographer. I enrolled in an ultrasound program the next week and found my passion.” It is a decision that continues to pay dividends. It led to a rewarding career and more education as she sought to move into leadership. “I am a continuous learner that needs to feel challenged in the work they do. I love my job because my organization does exactly that,” Amy says. “They invest in their people by providing opportunities to learn and grow. They also provide civic opportunities to give back to the local community, which is also very important to me.” Among her greatest accomplishments is work she completed 10 years ago. “In 2016, I went back to school for my MBA while working fulltime and raising my two children,” Amy recalls. “I was still taking call at the time as a sonographer and knew as a single mom I could not continue that. I needed to shift my career from bedside caregiver to leadership. I learned so much about time-management and developed self-discipline.” Her experience during that time also served to influence her leadership style.

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ADVANCING THE IMAGING PROFESSIONAL

“My approach is centered around a single phrase: ‘Keep the patient at the center of every decision I make.’ I achieve this by prioritizing patient experience, safety and team member engagement,” Amy shares. “While metrics and operational efficiency are important to any leader, I also focus on empowering my team and cultivating a culture of appreciation.” It sounds simple, but it can be challenging. It is an approach that takes dedication. “In my opinion, it is important to give frontline caregivers autonomy and the tools to make real-time decisions to improve the patients’ experience. This could be as simple as service recovery strategies or as complex as modality template building,” Amy says.,” Amy says. She is dedicated to the approach because of the results it delivers. “There is a direct correlation between employee engagement and patient satisfaction, therefore engaging and empowering my team is a priority,” she adds. A key aspect of Amy’s leadership approach is recognition. “It is also important for me to build a culture of appreciation. Large organizations are great at celebrating good catches and moments of extraordinary care; however, I believe those stem from the small things we do every day,” she says. “The technologist that stays late to help a colleague with a difficult protocol, the nurse that helps with a difficult IV, those small everyday things that happen when leadership isn’t looking. Those are the moments that build a great culture and thus provide better outcomes for our patients.” Her experiences with leaders influence the successful approach she implements today. “I was very lucky; I had two amazing mentors during my career,” Amy says. “My long-time director and vice president each mentored me and, honestly, were the two greatest influences in my career.” “When I was young in my career and a bit of a hot head – my vice president instituted the 24-hour rule with me. If I was angry, I had to wait 24 hours to send an email, make a phone call or have a difficult conversation with someone,” she recalls. “Such a simple thing but so impactful. It helped me gain perspective and approach problems from a practical place not an emotional one.” When recalling the work environment, she had earlier in her career, it seems to mirror Amy’s leadership goals. “My director created an environment where we were encouraged to find innovative solutions to operational issues. She valued our input and encouraged our independence. She gave us space to grow into our roles and supported us even through our mistakes,” she shares. “I have a group of energetic lead technologists in my current organization that I am excited to mentor. They have so much talent and are so passionate about the patients they serve. It will be a pleasure to watch their careers develop,” she adds. However, her current role did not come without some hesitation. “I relocated from Ohio to Georgia in December of 2025. I had a 25-year career with the same organization in Ohio before accepting this position with Piedmont. I was terrified to take the risk but also excited for new challenges. As Abraham Maslow said, ‘You either step forward into growth or step back into safety.’ I choose forward,” Amy says. Away from work, Amy says that she has “two amazing children.” It is safe to say they have a pretty amazing mom. •

AMY RUTLEDGE

MBA, CRA, RDMS, Director of Imaging Services at Piedmont Macon and Macon North Favorite sports team? Cleveland Browns Last show or series you binge-watched? “Mindhunter” One thing most co-workers don’t know about you? I compete in dog sports with my Belgian Malinois. We compete in Fast-Cat, which is a timed 100-yard dash, happy ratters and scent work. What is your hobby? I have 4 rescue dogs. A hound mix, a German Shepherd, a Belgian Malinois and a Husky mix. Since my Shepherd and Malinois are both high energy working breeds, I do a lot of training. I also enjoy hiking, kayaking and basically anything where I can be outdoors. One thing you do every morning to start your day right? Exercise, the dogs and I walk 2 miles in the morning. Then, I feed my coffee addiction. What is the best advice you ever received? Leave things better than when you found them. If you could have a superpower, what would it be? I would love to be able to speak to animals! What is the perfect meal? I could eat Italian food everyday – any kind of pasta. Who has had the biggest influence on your life? My parents have had the biggest influence on my life. They raised 17 foster children, plus myself and my 3 siblings. They instilled in all of us the need to give back and take care of others. What are you reading? “Emotional Intelligence 2.0”

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ICEMAGAZINE

SPOTLIGHT

Off Clock THE

KATHRYN FOLAND, RT(R), WITHAM HEALTH SERVICES OF LEBANON, INDIANA BY MATT SKOUFALOS

hether she’s working shifts at the hospital, taxiing her three sons among their daily activities, rearing livestock on the homestead, or teaching exercise classes at her barre studio in West Lafayette, Indiana, there are always demands on her time. Kathryn traces the roots of her medical imaging career to a radiologic technologist assistantship she began during her freshman college year at a local hospital in Crawfordsville, Indiana. As she put in shifts on evenings and weekends, the work gave her a practical education in what would become her full-time career. “I scheduled patients, transported patients and purged film; answered the phone, ran cassettes,” Kathryn said. “I enjoy helping people, and I’m a very visual learner, so it was the right path. It was something that I fell in love with.” “We’re that first step to diagnosing what’s going on with the patient when they initially come in,” she said. “It’s sometimes good and sometimes bad, seeing things from the very beginning coming through to the end.” At the same time that Kathryn was beginning her work in healthcare, she was keeping an eye on her grandfather, who was in and out of the hospital, regularly getting chest X-rays while battling emphysema and COPD. Her work as an imaging assistant didn’t seem to match up with the focus of her undergraduate studies, and so in 2010, Kathryn began X-ray school at the Ascension St. Vincent College of Health Professions.

ICEMAGAZINE | OCTOBER 2026

By then, she had married her husband, Jordan, and begun working in a nursing home. It wasn’t the best fit for Kathryn, and neither was studying physical therapy, another option with which she had been presented. Instead, she put herself up for a competitive program in Kokomo, Indiana, and landed the opportunity. During her second year of X-ray school, Kathryn was hired on as a student tech at Ascension St. Vincent, and stayed on after graduation as a working tech on a PRN basis. In 2013, she maintained those as-needed responsibilities while also taking on work at Franciscan Health until a full-time position opened up. Meanwhile, the couple had welcomed Brysen, the first of their three sons. After nearly a year of working nights and weekends with an hourlong commute on either end, the family relocated, and Kathryn left St. Vincent. She later took on work in outpatient clinics and similar settings before joining Witham Health Services of Lebanon, Indiana in February 2026. All along, however, Kathryn had kept up with an exercise routine that eventually led to her certification as a Pure Barre instructor. She began the process during 2020, qualifying for the tests over video and in home studios. Of the five different barre formats her home studio offers, Kathryn is certified in two of them, and today she teaches three to five classes once or twice a week. Classic is a low-impact, high-intensity, full-body, 50-minute workout that improves flexibility through toning and strengthening. The Define class fuses the Classic class format with heavier weight training to enhance muscular definition, perfect form and help students find a full range of motion.

ADVANCING THE IMAGING PROFESSIONAL

“I like barre because we’re a very low-impact workout,” Kathryn said. “It’s like Pilates and yoga and ballet combined together. We do a lot of hands-on corrections, while it’s still music-driven, so my brain is always working.” Kathryn says she enjoys barre instruction because the classes give her an opportunity to help people in a different way than in her day job at Witham Health. “It’s really cool to see clients from the beginning,” she said. “I get to see progress.” “I’ll have a client come in for the first time, and then 50 or 100 classes in, they’ve perfected the form and you can tell their toning, their mental clarity, their confidence has improved.” In addition to charting her clients’ progress, Pure Barre creates a social environment around fitness that makes everyone feel welcomed and invited. From ages 16 to 70, the people in her studio feel in community with one another around the opportunity to exercise. That is what Kathryn says motivates everyone to bring their best to the class. “Pure barre is my outlet,” Kathryn said. “That’s my peace and calming for the week. I don’t have to think about anything else. It’s a 50-minute class, no cellphone. It’s my time; it’s the clients’ time.” Kathryn also spends lots of time ferrying around sons Brysen, 12; Nash, 9; and Stetsen, 4, to the various activities of their childhood: baseball, basketball, 4-H and more. Another of the family’s most time-consuming activities involves animal husbandry. The Folands have begun showing pigs, sheep and rabbits at the Indiana State Fair as a way to carry forward activities that Kathryn and Jordan enjoyed in their own childhoods. “My husband and I both grew up showing pigs; I grew up showing sheep as well,” Kathryn said. “My brother raises show pigs now.” “You definitely want to connect with the right people that can help you,” she said. “It’s a big industry, but close-knit. Everybody knows everybody.” In addition to helping connect their sons with the work that is required to rear animals – feeding, walking, washing and cleaning their living spaces – some of the livestock are sent to market for slaughter, or for breeding by other farmers. “It’s not a cheap hobby, and it takes a lot of dedication,” Kathryn said. “You’ve got to feed them and walk them twice a day and make sure their muscle and skeletal structure is good. In order to be competitive, it’s a full-time job in itself.” Among the variety of activities in her life and those of her children, Kathryn sometimes has to remind herself not to overload her days. But she wouldn’t trade the peace of mind that barre delivers for anything else. “I love showing up for the clients and seeing them show up for me,” she said. “Any time I feel like I’ve got too much on my plate – kids, work, activities – I remind myself it’s good for my mental health to do something that’s not just being a mom and an X-ray tech. “There are always opportunities to work.” •

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Kathryn Foland enjoys activities that require focus and dedication. She and her husband, Jordan, help their three sons raise show animals for the state fair. Kathryn is a Pure Barre instructor.

ICEMAGAZINE

SPOTLIGHT

ICE Debut

or 75 years, ASG Superconductors has been at the forefront of superconducting technology. It is an Italy-based company specializing in the production of superconducting magnets, systems, and wires used in the research, energy, and medical sectors.

“From the magnets that enabled the discovery of the Higgs boson to record-breaking superconducting wires for power transmission, we have contributed to the world’s largest international research projects, such as the discovery of the Higgs boson in 2012 at CERN. But ASG also has important collaborations in the U.S., such as at Fermilab,” ASG Superconductors USA Inc. Head of North America Stephen Gibbs said. Q: CAN YOU SHARE MORE INFORMATION ABOUT ASG SUPERCONDUCTORS? A: As the company shifts its focus toward electrification and sustainability, superconductivity is becoming increasingly viable for cost-effective industrial and everyday applications, thanks to advances in materials and expertise. Our magnetic systems and superconducting cables – including our advanced MgB₂ high-temperature superconductor – are designed and manufactured in Italy but deployed worldwide, from Japan to Europe, from the UK to the UAE, and of course the U.S., drawing on solid expertise in physics, engineering, and manufacturing. With a team of 200 highly specialized employees and subsidiaries in Italy, France, the United States, and the United Kingdom, ASG Superconductors is a global leader in superconducting technology. Q: HOW DOES YOUR COMPANY STAND OUT IN THE IMAGING SECTOR? A: Superconducting technology has always played a fundamental role in the medical field. At ASG Superconductors, we use our expertise to develop patientcentered solutions. Our MgB₂-based technology powers the world’s only truly open, cryogen-free MRI system, the MROpen EVO, and supports advanced applications such as real-time MRI imaging for proton therapy. 16

ICEMAGAZINE | OCTOBER 2026

Our expertise in the fields of magnetism and superconductivity also extends to hadron therapy, cyclotrons for cancer treatment and the development of sophisticated highfield UHF magnets. We offer complete systems, components and services to companies in the medical sector. We are one of the few companies in the world capable of manufacturing magnets ranging from 0.5 to 17 T. Q: WHAT ARE THE FUTURE PROSPECTS FOR YOUR COMPANY? A: ASG has developed and is marketing an open-bore, cryogen-free MRI system based on proprietary technologies related to MgB₂ superconducting wire and magnets. ASG Superconductors USA’s goals are to expand and broaden access to the MROpen EVO system across all MRI imaging markets, to provide a solution that meets patients’ needs by making open MRI and positional imaging more accessible and usable, where appropriate, based on their clinical conditions. Q: IS THERE ANYTHING ELSE YOU’D LIKE TO SHARE WITH ICE MAGAZINE READERS? A: The MROpen EVO offers and integrates MRI services in a single, appropriate environment, which can positively impact the performance of exams in patients suffering from claustrophobia, anxiety or post-traumatic stress disorder. The MROpen EVO’s unique technological structure and design – enabled by magnets built with our MgB₂ superconductor – allows patients with complex body types, young patients, frail patients, immobile patients, those in pain or those unable to lie in the supine position to undergo an exam and receive the evaluation best suited to their needs. Imaging in different positions (standing, sitting, reclining) or positioning specific anatomical structures according to clinical indications can enable the treating physician to better assess the case in terms of weight distribution, cancer treatment planning, pain management or the evaluation of sports injuries. • For more information, visit mropenevo.com.

ADVANCING THE IMAGING PROFESSIONAL

NEWS

Imaging News A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

CLEVELAND CLINIC BREAKS GROUND ON AVON CAMPUS EXPANSION Cleveland Clinic leaders, caregivers, elected officials and community members gathered recently to celebrate the groundbreaking of a transformative $322 million expansion of Cleveland Clinic Avon Hospital and the Richard E. Jacobs Health Center. The multi-phase project will significantly increase the size of the campus and enhance access to advanced, patient-centered care for Lorain County’s growing population. The expansion reflects Cleveland Clinic’s continued commitment to meeting the region’s healthcare needs by increasing capacity across emergency, inpatient and outpatient services while introducing new capabilities and modernized facilities. “This marks an important milestone for the future of healthcare in Lorain County,” said Rebecca Starck, M.D., vice president and chief medical officer of Cleveland Clinic Avon Hospital. “As the community continues to grow, this investment ensures we can provide greater access to the highquality care our patients deserve. This project will enhance nearly every aspect of the patient experience while supporting the needs of our caregivers and the communities we serve.” Key components of the project include: • Expansion of the emergency department to increase capacity and improve patient flow • Expansion of imaging services, including advanced MRI, CT and other diagnostic capabilities • An expanded cancer center with enhanced treatment and infusion space and the addition of two new external beam radiation oncology machines

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• Growth of surgical services, including additional operating rooms at Avon Hospital • Expansion of the Richard E. Jacobs Health Center to support increased outpatient care • Increased medical-surgical capacity with additional inpatient beds • Growth of the intensive care unit (ICU) to support higher-acuity patients • Construction of a parking garage Upon completion, the project will add approximately 250,000 square feet of clinical space across the hospital and health center, along with a new parking garage to accommodate increased patient and visitor demand. Together, these enhancements will strengthen Cleveland Clinic’s ability to deliver seamless care across emergency, inpatient and outpatient settings while improving access, efficiency and the overall patient experience. The expansion is expected to be complete in 2029. The buildings were designed by HKS architects in collaboration with Cleveland Clinic Buildings + Design and key clinical stakeholders. The construction manager on the project is Gilbane Building.

ICEMAGAZINE

NEWS

AMIRIX MAMMOGRAPHY TUBE VALIDATED AND CERTIFIED

Amirix Imaging has announced the publication of an independent white paper evaluating its LM33-T X-ray tube’s performance in the Hologic Selenia Dimensions mammography system. Dr. Stefan Stryker, Ph.D., carried out the assessment, which is available for download at AmirixImaging.com. The white paper is a technical evaluation of the installed replacement tube measured against the OEM Varex M-113T. The evaluation, which is not a product announcement, used the same American College of Radiology (ACR) quality control guidelines that determine routine acceptance in accredited mammography facilities. Radiography, as a whole, is subject to intense equipment compliance assessments, but breast

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ADVANCING THE IMAGING PROFESSIONAL

imaging and mammography are particularly tightly regulated. Independent breast imaging assessments matter because they increase the likelihood that patients will receive the correct diagnosis and report from radiologists serving them. Systems currently in clinical practice must submit to periodic control testing via medical physicists’ surveys to ensure they offer a suitable level of performance to serve patients. Equipment that degrades image quality or alters automatic exposure control behavior can cause a facility to fall out of compliance with the rules. New regulatory approaches are shaping how imaging departments replace components. No longer is it acceptable to simply swap out an old part and fit a new one. Historically, clinical access to publicly available performance data has been limited. Many radiographers had to rely on vendor-supplied specifications or their own post-installation testing to verify compliance. Now live testing is the standard methodology. The new white paper validating Amirix’s imaging X-ray tube for Hologic’s mammography systems addresses that gap for this tube and this system specifically. It documents the full testing methodology and acceptance criteria, and evaluates the results, providing an assessment that gives medical physicists and imaging directors the technical records they need to weigh the quality of systems independently without simple summaries or claims. The independent white paper evaluated Hologic’s Selenia Dimensions Mammography System, comparing performance between the Amirix LM33-T and the OEM Varex M-113T. Testing methodology followed Hologic’s internal document quality control procedures in conjunction with the ACR. Acceptance criteria were drawn from published tolerances applicable to each test performed. The evaluation covered: • kVp accuracy and reproducibility across the clinical range • Radiation output, including output consistency • Beam quality, assessed through half-value layer (HVL) measurement across applicable target/filter combinations • Focal spot size • Radiation leakage • Automatic exposure control (AEC) performance, including response across phantom thicknesses

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• Image quality, evaluated using ACR phantom scoring • Signal-to-noise ratio (SNR) • Contrast-to-noise ratio (CNR) The results reveal that the Amirix LM33-T X-ray tube had performance equivalent to the OEM tube, or within applicable specifications. For example, beam quality (HVL) measurements, radiation output, and kVp accuracy were all within acceptable tolerances. Radiation leakage was below the applicable limits, and AEC behavior was consistent across various phantom thicknesses tested. Focal spot size was on specification, and other parameters like SNR and CNR were comparable to the Varex M-113T. These results confirm that the Amirix LM33-T is a suitable X-ray tube for Hologic Selenia Dimensions mammography equipment. To maintain honesty, the white paper is clear about limitations and scope boundaries. For example, it did not measure long-term durability or tube life. It is also only evaluated based on established quality control criteria at the time of testing. It did not go beyond them. Amirix Imaging said the following: “It was important for us that the LM33-T underwent proper testing in the way that a facility’s own physicist would measure it. We do not agree with the idea that service engineers and physicists should have to take a manufacturer’s word for how a component behaves once installed. They should have living proof. Now the LM33-T has been tested against Hologic’s internal quality control, as well as ACR guidelines and the official OEM tube. The results have been published in full, and there is a statement of what the study did not examine. We think this is the standard that all industries’ suppliers should be held to.” Many healthcare and medical professionals stand to benefit from the white paper, according to Amirix Imaging, including radiology administrators, biomedical engineering teams and independent service organizations. The white paper is useful for any institution looking for affordable Hologic Selenia Dimensions tube replacement options for mammography systems. The paper – including test conditions, methodology and results – is available in full for download at AmirixImaging.com. The results come with Dr. Stryker’s full conclusions and commentary.

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NEWS $24 MILLION BRINGS NEXT-GENERATION MRI TECHNOLOGY TO CHILDREN For children with painful orthopaedic conditions, waiting months for an MRI can mean waiting months to begin treatment. Luskin Orthopaedic Institute for Children (LuskinOIC) is working to change that. More than 200 physicians, patient families, community leaders and supporters gathered Tuesday at LuskinOIC’s Downtown Los Angeles campus as the nonprofit broke ground on a $24 million Innovation Campaign that will dramatically expand pediatric orthopaedic care and introduce one of the region’s first next-generation hybrid MRI systems. The new Advanced Imaging Center is expected to reduce MRI wait times from approximately two and a half months to just two and a half days, giving children faster access to diagnoses and treatment. The investment includes a new 3T Siemens MRI system that combines advanced MRI technology with CT-level diagnostic detail while eliminating radiation exposure for many pediatric patients. The campaign will also expand specialty clinics and patient care space to meet the growing demand for pediatric orthopaedic services across Los Angeles. Among those attending the groundbreaking were UCLA Women’s Basketball National Champions Sienna

Betts, Addy Brown, KK Bransford and Donovyn Hunter; Los Angeles City Council District 9 representative Jose Ugarte; Everychild Foundation Founder Jacqueline “Jackie” Jacobs Caster; LuskinOIC Board Chair Mark Zytko; benefactor Meyer Luskin; LuskinOIC President and CEO Dr. Anthony Scaduto; philanthropists, medical leaders, parents, patients, and LuskinOIC Leadership. For more than 115 years, LuskinOIC has provided specialized pediatric orthopaedic care regardless of a family’s ability to pay. Today, more than 80% of its patients are underinsured. In partnership with UCLA Health, the nonprofit provides more than 60,000 patient visits each year and remains the largest provider of pediatric orthopaedic care on the West Coast. The groundbreaking wasn’t simply about adding new technology. It was about helping children spend less time waiting for answers. For children like Andrea Pendarvis, whose scoliosis treatment was delayed for 8½ months while she waited for insurance approval for an MRI, reducing wait times isn’t simply about convenience – it’s about preventing conditions from worsening and getting children the care they need.

BEEKLEY MEDICAL INTRODUCES OLORA HALO Beekley Medical launched of Olora Halo, a nasal malodor barrier featuring a medical-grade, BPA-free clear silicone nasal ring with a clinically fresh, encapsulated scent that discreetly helps reduce unpleasant odors. Designed for clinical environments, Olora Halo helps care teams remain present, focused and engaged during patient interactions involving malodor. Strong odors associated with wounds, infections, gastrointestinal bleeding, body odor and other care situations can create discomfort and distraction for staff. Olora Halo provides a low-profile option that can be worn with or without a mask and does not interfere with verbal communication, facial expressions or routine workflow. “Clinical teams encounter challenging odors every day, but their ability to remain attentive and compassionate

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should not have to depend on simply powering through discomfort,” said Michael McGuire, director of strategic growth and innovation at Beekley Medical. “Olora Halo gives healthcare professionals a discreet, practical tool that supports their comfort while helping preserve patient dignity and focus on care.” During product-development field testing, clinicians used Olora Halo in their own facilities and shared qualitative feedback. An ultrasound technologist in Waterbury, Connecticut, said the product was “super comfortable to wear and very discreet” and, when worn with a mask, “almost eliminated the odor completely.” • Olora Halo is available, and healthcare organizations can learn more or request complimentary samples at tinyurl.com/yhcmnypa.

ADVANCING THE IMAGING PROFESSIONAL

INSIGHTS

DIRECTOR’S

CIRCLE WOMEN ’S IMAGING

dvances in women’s imaging and breast cancer screening are giving radiology directors and imaging leaders new opportunities to improve early detection, strengthen clinical workflows and enhance the patient experience. From digital breast tomosynthesis and contrast-enhanced mammography to breast ultrasound, MRI and artificial intelligence, healthcare systems and standalone imaging centers are evaluating how evolving breast imaging technologies can improve diagnostic confidence, efficiency and access to care. At the same time, imaging leaders face persistent challenges involving staffing, screening compliance, equipment investment, interoperability and patient access. For this Director’s Circle, ICE Magazine asked women’s imaging professionals to discuss the technologies shaping breast cancer screening, key considerations when purchasing breast imaging equipment and the clinical and operational trends expected to influence women’s imaging programs in the years ahead. The members of the Director’s Circle panel discussion on women’s imaging are: • Piedmont Macon Lead Mammography Technologist Laura Batchelor; • University Hospitals, Cleveland Medical Center Mammography Supervisor Jill Gullett, R.T.(R)(M); • Hartford Hospital Radiology Director Sandra Smith Phillips; • University Hospital Radiology-Mammography Supervisor Amy S. Reed, BS, CRA, R.T.(R)(M); and

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• UT Southwestern Medical Center Outpatient Imaging Operations Manager Tricia Trammell, BA, CRA, FAHRA, R.T.(R)(M)(QM)(BS), BHCN. Q: WHAT TECHNOLOGIES OR ADVANCEMENTS ARE HAVING THE GREATEST IMPACT ON BREAST CANCER SCREENING AND DETECTION TODAY, AND HOW ARE THEY CHANGING THE WAY YOUR ORGANIZATION APPROACHES WOMEN’S IMAGING? BATCHELOR: The advancements with DBT, AI and breast density assessment have made the greatest impact. The ability to find cancers earlier and smaller give our patients the ability to have a much better treatment plan and recovery. It also gives us the ability to look beyond mammography in the women who need additional screenings, such as women who have been identified as having dense breast tissue. Having AI as a second look to help with detecting subtle masses, calcifications and architectural distortion that might otherwise be overlooked. GULLETT & REED: Digital breast tomosynthesis (3D mammography) continues to have a significant impact on breast cancer screening and detection, particularly by improving visualization of abnormalities that can be obscured on traditional 2D imaging. Advances in ultrasound and breast MRI are also allowing us to provide more individualized diagnostic evaluation based on a patient’s risk factors, breast density and clinical presentation. We are increasingly focused on a more personalized approach to breast imaging rather than a one-size-fits-all model. Technology is helping us provide more comprehensive imaging while also improving workflow, efficiency and the overall patient experience.

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INSIGHTS PHILLIPS: Digital breast tomosynthesis mammography, breast ultrasound and breast MRI tend to be the ones with the greatest impact on screening and breast cancer detection. Each modality plays an important role, particularly for women with dense breast tissue or those at elevated risk. These technologies allow us to detect cancers earlier, improve diagnostic accuracy and reduce unnecessary callbacks. At Hartford Hospital, we have focused on expanding access to advanced imaging, streamlining pathways between screening and diagnostic services, and ensuring that patients receive the most appropriate imaging based on individual risk factors and clinical needs. Additionally, our mobile mammography program helps bring advanced screening services directly into underserved communities, improving access and health equity. TRAMMELL: Digital breast tomosynthesis (DBT), breast ultrasound and breast MRI have long been the standard tools relied upon for screening and detection. But there is a newer tool in our toolbox that is adding immense value today. That tool is contrast-enhanced mammography (CEM). While digital mammography and breast ultrasound are anatomical imaging procedures, CEM is like MRI in that it demonstrates not only anatomy, but also uptake of a contrast material, indicating increased vascularity. The combination of functional and anatomical information increases detection and lesion characterization. While MRI continues to be the standard for high-risk screening, pre-operative planning and/or monitoring treatment response, there are many patients who are simply not a candidate for breast MRI. Reasons for MRI incompatibility can include implants, body habitus/ BMI, claustrophobia, inability to lie prone and/or allergies to MRI contrast. These patients may be great candidates for CEM. Like MRI, if a lesion is seen on CEM, you need to have the ability to biopsy that lesion via CEM. That is an additional software package, so it is important to have that. Otherwise, you may identify a lesion and have no way to biopsy it if it is otherwise mammographically and sonographically occult. So, what is CEM? It is another extremely valuable tool in our detection toolbelt and often fills in the gaps that MRI would otherwise have left because of patient factors. Q: WHEN EVALUATING OR PURCHASING BREAST IMAGING EQUIPMENT, WHAT FACTORS ARE MOST IMPORTANT TO YOUR ORGANIZATION? BATCHELOR: Image quality is definitely the most important factor, but patient comfort is a high priority too. We are going to look for equipment that has a higher performance for dense breasts with the least amount of artifact and with the lowest radiation dose. It needs to easily ac22

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commodate different body types and different disabilities while keeping the exam time short. If a patient feels more comfortable and relaxed, it will be a much better exam. GULLETT & REED: Image quality is always the highest priority because ultimately our goal is to detect breast cancer as early and accurately as possible. However, we also look at the entire patient and technologist experience. Patient comfort is extremely important in mammography because a positive experience can influence whether a patient returns for her next screening. Workflow, ease of use, ergonomics, interoperability with our existing systems, reliability, and service and technical support are also major considerations. Cost is certainly a factor, but we look at the overall value of the equipment. A system that provides excellent image quality, improves efficiency, minimizes downtime, and supports our technologists and patients can have a much greater long-term impact than simply selecting the lowest-cost option. PHILLIPS: All of these are very important to us. Image quality is always our highest priority because early detection depends on obtaining the most accurate and detailed images possible. We also carefully evaluate patient comfort, workflow efficiency, interoperability with existing systems, service and support, and overall reliability. Technology should enhance the patient experience while allowing our teams to work efficiently and maintain high throughput. We look for solutions that support seamless integration across the healthcare system and provide long-term value through strong vendor partnerships and responsive service support. TRAMMELL: When it comes to breast imaging, vendor homogeneity is important to ensure image quality and consistency. Often when organizations have multiple vendors for mammographic equipment, you can end up with quite different looking images on the same patient from year to year from a contrast, noise and sharpness perspective. Additionally, the comfortability and proficiency of technologists may be improved with vendor homogeneity. Having said that, selecting a vendor that offers everything you are looking for (DBT, stereo, CEM) is important too. Q: HOW ARE TECHNOLOGIES SUCH AS 3D MAMMOGRAPHY, BREAST ULTRASOUND, BREAST MRI AND ARTIFICIAL INTELLIGENCE INFLUENCING SCREENING WORKFLOWS AND DIAGNOSTIC CONFIDENCE? BATCHELOR: 3D mammography with AI computer-aided detection has allowed us to take a closer look at areas that we may not have been able to see before. By visualizing areas on the mammogram, we have been able to better recommend further imaging with ADVANCING THE IMAGING PROFESSIONAL

I M AG I N G

LEADERS ultrasound and MRI. This has helped change how the workflow for screening and diagnostic exams are handled. We have been able to move from a single test model to a multimodality, risk-based, technology-assisted pathway. GULLETT & REED: These technologies have allowed us to become much more comprehensive and individualized in how we evaluate patients. 3D mammography has become an important part of our screening and diagnostic workflow, while ultrasound and MRI provide valuable additional information when mammographic findings require further evaluation or when a patient has increased risk. Artificial intelligence is an exciting area of development. We see AI as an additional tool to support the radiologist and technologist rather than replace clinical expertise. It has the potential to help identify subtle findings, prioritize cases, improve consistency and provide another layer of diagnostic support. The biggest opportunity is having these technologies work together seamlessly. When the information from mammography, ultrasound, MRI, prior examinations, patient history and AI can be efficiently brought together, it can improve diagnostic confidence and help us provide more timely and appropriate care. PHILLIPS: These technologies are significantly improving both workflow and clinical confidence. Three-dimensional mammography provides better visualization of breast tissue and improves cancer detection rates, particularly in women with dense breasts. Breast ultrasound and MRI offer valuable supplemental imaging for higher-risk patients and help characterize findings more accurately. Artificial intelligence is becoming an important tool by assisting radiologists with lesion detection, prioritization of suspicious studies and workflow optimization. While AI does not replace clinical expertise, it serves as an additional layer of support that can improve efficiency, consistency and confidence in image interpretation. Hartford Hospital has embraced AI across several imaging applications and continues to evaluate emerging technologies that enhance patient care and operational performance. TRAMMELL: I have been in breast imaging for over 25 years – since the darkroom days! Things have changed so much! All the tools available today are improving the radiologist’s confidence. But there is no AI tool more valuable than a skilled breast radiologist. They always have the final say. They are the experts who see things and follow their instincts and intuition. And unlike many other kinds of radiologists, breast radiologists must have excellent communication skills and interact with patients. Breast interventionalists are performing biopsies on their own or their colleague’s findings. These procedures can be some of the scariest moments in a patient’s life. There is no tool or AI magic that can truly make a breast radiologist amazing at getting a patient through a procedure when they feel scared not only of the procedure, but even more of the outcome. I feel very blessed to work with world-class, fellowship-trained breast radiologists who are empathetic and care deeply about their patients. THEICECOMMUNITY.COM

LAURA BATCHELOR PIEDMONT MACON

JILL GULLETT

UNIVERSITY HOSPITALS

SANDRA SMITH PHILLIPS HARTFORD HOSPITAL

AMY S. REED

UNIVERSITY HOSPITALS

TRICIA TRAMMELL UT SOUTHWESTERN MEDICAL CENTER

INSIGHTS Q: WHAT ARE THE BIGGEST CHALLENGES FACING WOMEN’S IMAGING PROGRAMS TODAY, AND WHAT STRATEGIES HAVE BEEN EFFECTIVE IN ADDRESSING THEM? BATCHELOR: One of the biggest challenges is staffing and burnout. These shortages are causing longer wait times, delayed diagnostic imaging and procedures, and increased workload. Also, getting women to begin having screening exams and continue to follow up every year at the same facility is important. There are many different factors that keep women from doing their screening exams and possibly cause them to start having them at a different facility such as cost and insurance issues, transportation, limited access, fear and anxiety. Many of these things we are able to assist with to make it easier for women to get the care they need. GULLETT & REED: Staffing and patient access continue to be two of the biggest challenges. Mammography requires highly specialized technologists who not only have technical expertise but also understand how to communicate with patients and provide compassionate care during an often-sensitive examination. Recruiting and retaining experienced mammography technologists can be difficult. We also continue to focus on making screening as accessible and convenient as possible. Offering extended access, screening throughout the day, Saturday appointments, efficient scheduling and minimizing unnecessary barriers can make a meaningful difference. Another major challenge is screening compliance. We can have excellent technology and highly skilled staff, but it only helps the patient if she actually comes in for her screening. Education, patient reminders, convenient scheduling and creating a positive experience are all important. From an operational standpoint, we have also focused heavily on standardizing workflows across multiple locations, improving communication between teams and using technology to make scheduling and patient flow more efficient. PHILLIPS: Like many organizations nationwide, staffing continues to be one of the greatest challenges. Recruiting and retaining qualified mammography technologists and breast imaging specialists remains highly competitive. Patient access and screening compliance are also ongoing concerns, particularly for underserved populations. To address these challenges, we have focused on workforce development, flexible staffing models, community outreach initiatives and technology solutions that improve workflow efficiency. Our mobile mammography services have been particularly effective in expanding access and helping to reduce barriers to screening. We have also emphasized patient education and engagement to encourage adherence to recommended screening guidelines.

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TRAMMELL: Many grants that were once in place that paid for screening mammography for uninsured women no longer exist, so access for those women has now become an issue. Breast programs will always have to keep a pulse on staffing, compliance and reimbursement to maintain sustainability. The goal for a breast program should be to meet the needs of that community, so the goals may be a little different for every community. But growing the program is essential to its sustainability. To do that, you must continually maintain and improve access. We have learned to become resilient in these times of change. Q: LOOKING AHEAD THREE TO FIVE YEARS, WHAT DEVELOPMENTS IN BREAST CANCER SCREENING OR WOMEN’S IMAGING TECHNOLOGY DO YOU BELIEVE WILL HAVE THE GREATEST IMPACT ON PATIENT CARE AND IMAGING OPERATIONS? BATCHELOR: I think the advancements of contrast-enhanced mammography (CEM) and abbreviated breast MRI along with adding in the risk factor and breast density will help women with dense breast tissue be able to get better cancer screenings. With high-risk programs we are able to identify the women who may not be aware that they are eligible for these extra screening exams. Abbreviated screening breast MRI protocols allow us to minimize the time patients are in the scanner, which helps reduce their anxiety. Contrast-enhanced mammography will be an important, complementary exam to breast MRI. GULLETT & REED: We believe artificial intelligence will have one of the greatest impacts over the next three to five years. As AI becomes more sophisticated, it may increasingly assist with detection, interpretation, risk assessment, workflow prioritization and quality assurance. We also expect continued advancements in personalized screening based on individual risk, breast density, genetics, family history and prior imaging. The future will likely involve moving further away from a universal screening approach and toward determining the most appropriate imaging strategy for each individual patient. We are also hopeful that technology will continue to improve patient comfort and technologist ergonomics while increasing efficiency. Equipment that can provide excellent image quality while reducing examination time, improving workflow and minimizing downtime benefits everyone. Ultimately, we think the greatest advances will come from integrating these technologies rather than looking at each one individually. PHILLIPS: I believe the continued advancement of artificial intelligence will have a transformative impact on breast imaging. AI will become increasingly integrated into screening workflows, helping prioritize studies, identify subtle abnormalities, reduce variability and improve ADVANCING THE IMAGING PROFESSIONAL

Our goal should always be the same: provide the right imaging, at the right time, with the best possible technology and the most compassionate patient care.

efficiency. We will also see greater adoption of personalized screening strategies that combine imaging findings, breast density, genetic risk factors and patient history to create more individualized care pathways. Advances in MRI technology and contrast-enhanced imaging may further improve our ability to detect cancers earlier while minimizing unnecessary procedures. Ultimately, these innovations will support more precise, patient-centered care while helping healthcare organizations manage growing imaging volumes. TRAMMELL: Finding ways to make contrast-enhanced mammography more efficient so we can offer it to more screening patients is the future for breast imaging and screening programs. This is exciting because we know we will find more cancers than with digital mammography alone. Q: IS THERE ANYTHING ELSE YOU WOULD LIKE TO SHARE WITH ICE MAGAZINE READERS REGARDING WOMEN’S IMAGING? BATCHELOR: I think that we just want to make sure that we are having earlier detection with less burden on the patients and the staff technologists. Breast imaging is growing and advancing quickly, and women need to know that the exam they had years ago is not the same exam they can expect today. GULLETT & REED: One of the most important things we would emphasize is that technology is only one part of the equation. The people behind the technology matter tremendously. Mammography technologists play a critical role in breast cancer detection. They need extensive technical training, excellent positioning skills, attention to image quality and the ability to communicate compas-

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sionately with patients who may be anxious or fearful. A high-quality image depends not only on the equipment but also on the expertise of the technologist. As we continue to advance technologically, we also need to invest in the people who deliver this care. Supporting education, professional development, recruitment, retention and recognition of breast imaging professionals is essential to maintaining high-quality women’s imaging services. Our goal should always be the same: provide the right imaging, at the right time, with the best possible technology and the most compassionate patient care. PHILLIPS: Women’s imaging is about much more than technology. It is about ensuring that every woman has access to timely, high-quality screening and diagnostic care regardless of where she lives or her personal circumstances. Early detection remains our most effective weapon against breast cancer. We must continue to invest in education, outreach, innovation and workforce development to ensure that all patients benefit from advances in imaging. As a breast cancer survivor who underwent a double lumpectomy earlier this year, I have personally experienced the importance of early detection and high-quality breast imaging. My experience has reinforced my commitment to expanding access, improving patient experiences and encouraging women to make screening a priority. Every screening exam has the potential to save a life. TRAMMELL: The advancements in the industry of breast cancer detection over the past 25 years are astonishing. It has been an honor to watch these advancements over my career, and I am so proud to be part of this important mission. I am excited to see what the next decade will have in store! •

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PRODUCTS

Market Report

3D MAMMOGRAPHY, AI ADVANCE WOMEN’S IMAGING MARKET STAFF REPORT

dvances in 3D mammography, artificial intelligence and breast imaging technologies are influencing equipment investments as healthcare organizations look to strengthen breast cancer screening and diagnostic services. Women’s imaging continues to be an important area of investment for hospitals, health systems and outpatient imaging providers. For imaging leaders, the mammography market is evolving beyond the transition from 2D to 3D imaging as digital breast tomosynthesis (DBT), artificial intelligence and other technologies reshape breast imaging programs. Market research points to continued growth. Grand View Research valued the global mammography equipment market at $2.8 billion in 2025 and projects it will reach $6.4 billion by 2033, representing a compound annual growth rate of 10.8% from 2026 through 2033. The research firm reported that North America accounted for 35.2% of the global market in 2025. Fortune Business Insights offers another measure of the market, estimating the global mammography systems market at $2.49 billion in 2025. The firm projects the market will grow from $2.69 billion in 2026 to $4.77 billion by 2034, a compound annual growth rate of 7.4%. According to the report, North America accounted for 44.58% of the market in 2025. DBT, commonly called 3D mammography, remains one of the strongest areas of growth. Fortune Business Insights valued the global DBT market at $3.48 billion in 2025 and projects it will reach $11.15 billion by 2034, representing a compound annual growth rate of 13.83% during the forecast period. According to Fortune Business Insights, DBT captures breast images from multiple angles, allowing radiologists to examine tissue layer by layer. The research firm reports that the technology can reduce the effects of overlapping breast tissue and improve lesion visibility compared with conventional mammography. Grand View Research also identifies 3D systems as the fastest-growing segment of the mammography equipment market, citing advantages including increased procedure volumes, improved breast cancer detection and favorable reimbursement. For imaging leaders considering equipment replacement,

ICEMAGAZINE | OCTOBER 2026

the trend makes DBT capability an increasingly important consideration. Purchasing decisions, however, can extend beyond the mammography unit to workstations, image storage, PACS integration, software upgrades and service requirements. Breast density has also become a more visible component of breast imaging. The U.S. Food and Drug Administration requires mammography facilities to comply with updated Mammography Quality Standards Act regulations, including national breast density notification requirements. The requirements took effect Sept. 10, 2024. According to the FDA, mammography facilities must provide patients with information about their breast density as part of their mammography results. The agency says mammography remains the most effective primary screening method for detecting breast cancer in its earliest, most treatable stages. The requirements add another consideration for imaging departments as patient conversations about breast density and screening become more prominent. Artificial intelligence (AI) is also expanding within women’s imaging. Grand View Research reports that technological advancements, including AI integration, are helping improve diagnostic accuracy and workflow efficiency in mammography workstations. The firm valued the global mammography workstation market at $33.7 million in 2024 and projects it will reach $51.1 million by 2030, representing a compound annual growth rate of 7.2%. For imaging administrators, adopting AI requires evaluating more than clinical capabilities. Integration with mammography systems, PACS and reporting workflows, along with software licensing, cybersecurity and long-term support, can influence the technology’s overall value. As the market evolves, imaging leaders face increasingly complex capital decisions. Mammography equipment must deliver image quality while supporting efficient workflows, interoperability and future upgrades. The growth forecasts for mammography and especially DBT suggest that women’s imaging will remain an active area of technology investment. For imaging leaders, successful capital planning will increasingly depend on selecting platforms capable of meeting today’s screening demands while adapting to the next generation of breast imaging technology. •

ADVANCING THE IMAGING PROFESSIONAL

Product Focus Women’s Imaging

SIEMENS HEALTHINEERS Mammomat B.brilliant

New features for contrast-enhanced mammography exams on the Mammomat B.brilliant mammography system from Siemens Healthineers can boost the confidence of interpreting radiologists, even when examining dense breast tissue. The system’s ClearCEM image reconstruction technique provides improved lesion enhancement and consistent image quality for lesion detection. Its advanced algorithms suppress image noise, generating a more uniform background to help radiol-

ogists better identify suspicious areas in breast tissue. This image quality supports clinical decision-making and may enable clinicians to initiate treatment more quickly, while also reducing the need for additional imaging or unnecessary biopsies. ClearCEM also provides a scout image for tomosynthesis-guided biopsy that permits targeting accuracy within ±1 mm, potentially reducing time to diagnosis.

*Disclaimer: Products are listed in no particular order.

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PRODUCTS GE HEALTHCARE

Invenia Automated Breast Ultrasound (ABUS) Prime and ABUS StreamVue GE HealthCare is expanding its breast imaging portfolio with Invenia Automated Breast Ultrasound (ABUS) Prime and ABUS StreamVue, designed to support supplemental screening for women with dense breasts and provide more flexible enterprise-wide exam review. Together, these new solutions aim to help breast imaging programs standardize 3D ultrasound acquisition, support remote reading, and simplify deployment across multi-site networks. Invenia ABUS Prime features AI-enabled and workflow tools designed to boost scan quality, patient comfort and reading efficiency, including: • cSound Imageformer with AI-enabled tools including Scan Quality Assessment and Auto Nipple Detection developed to help deliver consistent, reproducible, high-quality scans and greater clinical confidence. • A Fast Scan tool that increases scan speed by up to 40%, along with a new-generation Reverse Curve transducer and selectable compression levels intended to enhance patient comfort • AI-supported reading powered by QVCAD is designed to streamline review. • ABUS StreamVue, a zero-footprint, browser-based reading solution built to standardize ABUS exam review with remote access.

The Koning Vera Breast CT system produces true isotropic 3D images of the breast in less than 10 seconds per side. The system images patients while they are lying comfortably in a prone position and does not require painful breast compression associated with conventional mammography. Koning Vera produces true three-dimensional images with exceptional spatial resolution, offering a comprehensive view of the breast. This dedicated breast CT technology eliminates the need for compression, improving patient comfort while maintaining diagnostic clarity. Built for precision, Koning 28

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KONING HEALTH Vera Breast CT

Vera enables physicians to assess lesions and tissue structures with confidence, supporting more informed clinical decisions. Its advanced imaging capabilities are designed to complement existing modalities, enhancing the diagnostic toolkit for breast health specialists. For patients, the experience is faster, more comfortable, and less intimidating – factors that may encourage more women to undergo regular imaging. For clinicians, Koning Vera represents a step forward in imaging innovation, designed with both workflow efficiency and clinical excellence in mind. ADVANCING THE IMAGING PROFESSIONAL

HOLOGIC

I-View 2.0 Contrast-Enhanced Mammography Software

Hologic I-View 2.0 Contrast-Enhanced Mammography Software helps radiologists see more when diagnostic confidence matters most. Contrast-enhanced mammography (CEM) combines standard mammography images with additional images acquired after contrast administration, helping reveal areas of enhancement that may not be fully visible on conventional imaging alone. With the I-View 2.0 software, radiologists can create comprehensive diagnostic studies designed to deliver exceptional clinical detail and sensitivity – supporting more confident assessment and clearer guidance for the patient’s next step. For breast imaging teams, CEM offers a powerful, efficient tool in the diagnostic pathway following a screening mammogram. It provides detailed functional and anatomical information in a familiar mammography environment, helping practices expand diagnostic capabilities. Studies have shown that contrast-enhanced mammography provides diagnostic performance comparable to contrast-enhanced breast MRI. Built on Hologic’s leadership in breast health innovation, the I-View 2.0 software empowers radiologists with the clarity, confidence and clinical detail needed to help guide care decisions. Because when subtle findings matter, enhanced visualization can make all the difference. •

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COVER STORY

EXPANDING REACH IN

WOMEN’S IMAGING: Mobile Care, Telehealth & Cultural Competencies BY MATT SKOUFALOS

ICEMAGAZINE | OCTOBER 2026

ADVANCING THE IMAGING PROFESSIONAL

or years, Dr. Kimberly Winsor has been working to provide diagnostic imaging services for breast health in Native American populations in rural locations across the American Southwest. As a fellowship-trained breast radiologist at Sedona Diagnostic Ultrasound in northern Arizona and previously with Diagnostic Imaging Associates in Tulsa, Oklahoma, Winsor has identified “a huge disparity in standard-of-care breast imaging” among communities in the Indian Health System (IHS), those organized under Public Law 93-638, the Indian Self-Determination and Education Assistance Act, and the standard of diagnostic care that many other Americans can access reliably.

Winsor and her partner, sonographer Chilali Vian, began operating a breast ultrasound clinic at Chinle, a community of 4,500 to 5,500 people in the center of the Navajo nation in Apache County, Arizona. She described Chinle as “an extremely remote site” that is richly beautiful in the high desert, but home to significant poverty. Many residents don’t have running water or reliable electricity in their homes, making the effort to deliver imaging services there akin to a domestic medical mission environment. Mobile imaging units account for a significant part of the screening imaging services provided in the region, but the distributed nature of the work means that when a study results in a finding, follow-up care can be likewise challenging to coordinate. Cancer incidence is lower – but less likely to be identified in the earlier stages of the disease – and health literacy is limited, so Winsor and Vian began spending two days per month there, Winsor described much of the disparity as being rooted in historseeing as many patients as possible for breast ultrasound, biopical attitudes surrounding settler colonialism and the early politics sies and consultations that make the experience meaningful to of “managing” the native populations from a Western perspecthe people they treat. tive and later by healthcare being used as a bargaining tool in “When we first started going out there, we were seeing peocontroversial treaties. In conjuncple waiting more than a year after tion with chronic underfunding of being called back for a suspicious the IHS, it’s a gulf practitioners still abnormality,” Winsor said. “It took work to overcome to deliver health us two years to catch up to seeing screenings in a culturally appropripatients who were having complaints ate fashion for communities that in the last two months.” are farther-flung from urban or “There’s seriously no place for even suburban population centers. these people to go,” she said. “It’s of“We talk about the formation ten too far (3 hours by car) for them of the IHS as a way for the U.S. milto travel into Flagstaff, and a lot of itary and the incoming white setpeople don’t have the transportation tlers to protect themselves from or the resources [to make the trip].” any sort of diseases and trauma Cancer detection rates increase in that could come from the indigeconjunction with an uptick in mamnous population,” Winsor said. mography studies performed; at the In delivering that promised same time, mammography screening healthcare, Western-style mediprograms can result in a 30 to 40 cine arrived in native communities percent reduction in patient mortality on condition of patients abandonby connecting patients to services ing traditional tribal practices, put- DR. KIMBERLY WINSOR earlier. However, Winsor said that ting them at odds with their own reduction has not been documented cultural histories. It drove a wedge in the American Indian population between the two worlds, creating with whom she works for a numpsychological and emotional barriers that practitioners like Winber of reasons, including a lack of access to advanced imaging sor have had to overcome generations later to perform cancer modalities, like breast MRI and 3D breast ultrasound, as well as screenings in parts of America that major healthcare institutions a dearth of skilled staff to conduct those studies and interpret don’t reach. their results. The vast expanse of rural reservation lands in the American “A lot of times, imaging technologists are travelers,” WinSouthwest present significant geographic barriers to quality sor said. “They may have varying levels of experience with the care. “Patients can travel for hours to get basic mammography equipment and protocols, and you have to train them again. services,” Winsor said. “It’s often difficult for them to get back Even with radiologists’ interpretations, it doesn’t make sense to [to a provider] for different views, ultrasound, a biopsy. For most hire a fellowship-trained breast imaging specialist if you only do larger or urban breast imaging centers, if they see something on five mammograms a week.” a screening, a work-up takes a couple of weeks, whereas here, it Cultural insensitivity and racism also persist, she said. may take many months.”

“This isn’t necessarily an expensive problem that can be fixed by technology, it’s a matter of talking to people and understanding where they’re coming from. That patientcenteredness can be really hard to find in this setting.”

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COVER STORY “It’s a huge issue with attitudes, first and foremost,” Winsor said. “This isn’t necessarily an expensive problem that can be fixed by technology, it’s a matter of talking to people and understanding where they’re coming from. That patient-centeredness can be really hard to find in this setting.” Winsor’s solution has been to establish a telemammography company called DayHawk. Its objective is to connect underserved rural patients who have abnormal imaging findings with fellowship-trained, offsite breast radiologists for high-quality radiology interpretations. DayHawk also wants to close that care loop with connections to a robust group of nurse navigators and social workers who are versed in the cultural practices of their communities, and who can liaise with staff on the ground for patient next steps. “In most developed places, that patient would show up in a breast imaging facility and be able to see a breast radiologist onsite,” she said. “I think it will take a large network of people in a remote capacity to provide that basic level of care to these underserved areas.” Winsor said the most successful interventions she’s seen in working to bring diagnostic imaging to women in remote regions of Arizona and Oklahoma have come from patient word-of-mouth endorsements. Her outreach efforts in Chinle began with two-thirds of her calendar slots being no-shows; now, after two-anda-half years of consistent outreach, every appointment she offers typically is filled. That turnaround was built by forming multidisciplinary connections with local staff and medicine men, and by delivering on the services that she promised. “You can’t force and you can’t expect it,” Winsor said. “When patients feel comfortable, they bring imaging to other family members.” Christie Devine, women’s health product manager at Siemens Healthineers North America, said that supporting community health outreach through mobile imaging services partnerships – such as those connected with Winsor’s work

ICEMAGAZINE | OCTOBER 2026

– is “a huge undertaking, but one we’re happy to do.” The most successful health screening outreach initiatives turn on community partnerships with the patient populations they serve. Although Siemens Healthineers can facilitate pop-up events by sourcing imaging technologists to conduct the studies themselves, finding practitioners who can loop patients into a continuum of care after the results are delivered is a heavier lift. Devine praised Winsor for conducting her work in a culturally significant way that benefits the people served by it. “The first thing we do need to ask is that our partners are able to find a radiologist to read them,” Devine said. “That’s one thing we’re not able to provide due to licensing. We need to make sure they’re capable and willing to take on the follow-up care as well.” The logistics of hosting an outreach event also involves working with partners in the study area to identify the best time, place and manner of delivering services. Sometimes the most ideal opportunities for doing so may be in off-hours or weekends, to facilitate the schedules of women who work multiple jobs, provide caregiving or other responsibilities. “We’ve done things to be able to get patients screened at a time that works for them that may not be the typical open hours,” Devine said. “People work with the organization to understand the challenges in this area. Karen Anderson, our key opinion leader, scientific manager, mammographer, and breast health advocate, has a great way of developing these relationships.” Once such partnerships are identified within the communities where screening initiatives are to be conducted, Siemens Healthineers assigns a dedicated team of outreach professionals to advertise their events, promote them within the community and coordinate those efforts with the partner organizations. When it comes to the imaging modalities involved, Siemens further works to account for any disparities in technologist training with equipment advancements

like 50-degree, wide-angle tomosynthesis technology, a 3D mammography format that can help identify cancers sooner and more definitively. Thereafter, Devine said, Siemens breast imaging pop-ups are designed “to help create a relationship that can lead to more appropriate care once a mammogram has been completed.” “Once you can get someone to the room, that patient’s going to have the best experience that they can, and we want people to return, even if they don’t have a finding today,” she said. “When you have an expert like Dr. Winsor, the care is right there.” Similar to the challenges of reaching women in distributed communities across the American Southwest, pediatric cardiologist Dr. Karen Rheuban, director of the University of Virginia (UVA) Health Center for Telehealth, has overseen the development of a telemedicine blueprint for the Appalachian community utilizing networks and partnerships across the state. Rheuban, who calls herself the “chief cheerleader” of such technological outreach, said that remote healthcare options allow physician providers who’ve long traveled to remote locations across the state to deliver services to remote parts of Virginia that would otherwise require patients to travel hours to the nearest clinic. “We host subspecialty clinics in distant community settings across Virginia one or two days every month. Before we had established telemedicine partnerships in these communities, if we were not physically present, our patients needed to either travel many hours to see us, or receive no subspecialty care for considerably complex conditions,” Rheuban said. Rheuban said it’s been “gratifying to see our telemedicine program blossom as we approach nearly 1 million telemedicine encounters supported by federal and state grants, philanthropy and local partnerships across Virginia.” She’s testified before U.S. Congressional and Virginia General Assembly committees multiple times, urging elected officials

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to expand coverage in Medicare and Medicaid in support of telehealth options for patients in rural and urban areas. Rheuban points to federal and state waivers and flexibilities, and Federal Communications Commission and U.S. Department of Agriculture programs approved during the novel coronavirus (COVID-19) pandemic, as “transforming” how care is delivered. “Prior to the issuance of COVID flexibilities, with a few exceptions, in order to be reimbursed for providing a telemedicine service to a Medicare beneficiary, patients had to travel to an eligible healthcare facility in a rural area,” she said. By statute, Virginia chose to continue many of the COVID-era waivers that expanded telemedicine coverage for Medicaid beneficiaries and for those covered by commercial insurance plans. Medicare has extended those flexibilities, enabling patients to be seen at home, whether from rural or urban locations, through December 31, 2027. Now, as much as 11 percent of the ambulatory visits conducted by UVA Health are provided via telemedicine, and because patients don’t have to drive, pay for parking or gas, or account for long travel times in their appointments, they’re returning the highest levels of satisfaction scores. “We’ve proven to our leaders that their investment in telehealth has borne fruit, improving access and patient engagement. We partner with community hospitals, federally qualified health centers, free clinics and other entities across the state,” Rheuban said. In addition to offering mobile mammography, the UVA telehealth program is working on a proposal to house a mobile van within a federally qualified health center (FQHC) network serving Appalachian women, which would deliver the technology to those brick-and-mortar sites to serve patients closer to where they live. The proposal would cover screening and diagnostic mammography, with locally

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provided care that loops in their comprehensive cancer centers. It would also offer patient navigation services, affirming trust in the capabilities of remote outreach, “and an understanding that we’re here to help,” Rheuban said. “A lot of our work has been grant-supported, but our goal is to remain in the community, be a valued and trusted partner, and support patients where they are,” she said. “Through telemedicine distance does not have to mean destiny.” Dan Wassilchalk, MHSA, recently retired as chief operating officer for the department of radiology and medical imaging for UVA Health, said that academic medical institutions like UVA have a significant responsibility to support patient care, teaching, research and community outreach in all areas they serve. “The issue of access to care, to me, is the social-economic challenge of taking high-end, advanced imaging equipment, and reaching far-rural parts of the country,” Wassilchalk said. “How are we able to use IT as a connector to those communities, but also, how do we tie it to an electronic patient record, where advanced specialists are able to determine the next best steps for care?” Patients in the Appalachian region are challenged to find the time to break away from daily activities like work, child-rearing or homesteading tasks for a diagnostic health exam, he said – particularly one inviting follow-up care that also takes them away from home for extended periods of time. “Urban and suburban opportunities have access to this care more conveniently,” Wassilchalk said. “It’s not always the economic challenges of affordability and insurance coverage; it’s also the social logistics of being able to have the exam and follow up accordingly. Decisions have to be made, or prioritized, and women in particular will often put themselves

LEADERS

CHRISTIE DEVINE SIEMENS HEALTHINEERS

KIMBERLY WINSOR

DIAGNOSTIC IMAGING ASSOCIATES

DANIEL WASSILCHALK UVA HEALTH

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“All of these challenges come into play as social determinants that need to be considered. Access to care needs to be as convenient as possible and as affordable as possible.” - DANIEL WASSILCHALK

on the back burner in favor of taking care of the family.” “All of these challenges come into play as social determinants that need to be considered. Access to care needs to be as convenient as possible and as affordable as possible,” he said. “Early cancer detection saves lives and also costs less in the long run in terms of treating a patient that may be at Stage 1 versus a latter stage of the disease.” Wassilchalk believes that it’s also important for academic, integrated health systems to deliver the level of care and follow-up that is necessary for those patients because such institutions also bring the kinds of outcomes-driven research found in an academic setting. “If research can enable us to evaluate these healthcare disparities and identify these social determinants, then something can be done about making it easier, simpler, more accessible for these patients in rural regions, and then state dollars can be made available as evidence-based outcomes are demonstrated that justify these types of grant dollars being spent,” he said. One such example of that intersection of public health priorities, community

ICEMAGAZINE | OCTOBER 2026

partnerships and the resources of a federally supported academic institution is a proposed Rural Health Transformation grant to provide sustained breast cancer screening wraparound services. Rheuban and UVA Health Director of Teleradiology Debbie King are working to move that application forward in partnership with Tri-Area Community Health, which operates “in a part of Appalachia that’s home to one X-ray technologist who covers multiple clinics,” Wassilchalk said. The linchpin of the program? A single X-ray and ultrasound-trained tech who said she would undergo mammography training to perform those women’s breast imaging exam in the community if the grant is awarded. “On the spot and in front of the radiology tech, I called back to UVA Radiology, and spoke with one of my key counterparts who oversees tech training and said, ‘Can we provide training for this individual?’ ” Wassilchalk said. “Would we be able to not only accommodate her in terms of room and board, but provide the training as well, for free? My counterpart said, ‘Absolutely.’ The tech was shocked and thrilled, while the clinic staff immediately started to clap.”

“That’s what it takes sometimes,” Wassilchalk said. “When you’ve got the ability to provide patient care, the ability to teach and the ability to conduct evidence-based research that can not only justify and validate the outcomes but then spread the service as well, it kind of gives the advantage to the academic provider.” Beyond building that capacity in its vocational staff, however, Wassilchalk further underscored the need for continued outreach that respects local culture and the needs of the population the program aims to serve. “If we come into a culture saying, ‘Here we are; we’re coming to save the day,’ that is not going to work,” he said. “The approach needs to be humble to understand and appreciate the culture, and to teach, most importantly, the benefit socially, clinically and, of course, economically, so that the community can actually help us by spreading the word, making themselves available and going through the process. That’s a huge component to determining the success of this opportunity.” •

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Photo Credit: Courtesy of ASRT

ADVOCACY BEGINS WITH THE PATIENT BY MEREDITH CHECK

or ASRT, advocacy begins with how policy decisions affect the people receiving medical imaging and radiation therapy services.

Advocacy starts long before a bill is introduced, a rule is published or a member receives a Take Action email. It starts with a patient who needs an imaging procedure or radiation therapy treatment and with the professionals responsible for providing that care safely and competently. In an imaging department, policy is not theoretical. A change in policy can affect who performs an examination, what education and clinical preparation they have, how a patient is supervised, how quality and safety are maintained and who is accountable when something goes wrong. The American Society of Radiologic Technologists looks beyond the stated purpose of a proposal and examines what it would mean in practice. ROOTED IN PATIENT CARE Proposed legislation and regulations involve staffing, access, cost, licensure or how a state defines who may perform a procedure. ASRT considers those factors, but the Society starts with the effect on patients – what the change would mean for the person receiving the examination or treatment. From there, the review becomes practical: • What would change in practice? • What education and clinical preparation would the work require? • How will competency be verified? • What supervision or licensure applies? • Who is accountable for the outcome? • How does the proposal align with the ASRT Practice Standards for Medical Imaging and Radiation Therapy, ASRT Position Statements and other professional standards?

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Those questions keep advocacy focused on the care patients actually receive. Workforce and access concerns matter, but they do not answer whether the people performing a procedure have the education, clinical preparation, competency, supervision and accountability required for the work. HOW POLICY DECISIONS REACH PATIENT CARE ASRT supports legislation that expands patient access to quality radiology care. That’s one reason the Medicare Access to Radiology Care Act (MARCA) remains the Society’s top legislative priority. MARCA is proposed federal legislation that would allow Medicare payment to an employer for services performed by radiologist assistants practicing as part of radiologist-led teams. Some patient-care connections are less obvious than licensure debates. ASRT submitted comments on a U.S. Department of Education rule affecting how the department classifies advanced degrees for radiologist assistants. The department did not adopt ASRT’s recommendation and classified advanced degrees for radiologist assistants as graduate degrees rather than professional degrees, but it addressed ASRT’s concerns directly in the final rule’s justification. That response matters because federal policy can influence how advanced practice roles are described and understood. Policy that looks technical on the surface can still affect the care environment. ASRT evaluated the Nuclear Regulatory Commission’s proposed revisions to radiation protection regulations, a package that included more than 300 pages of material. ASRT also has been evaluating proposed payment rules from the Centers for Medicare & Medicaid Services and tracking the Office of Management and Budget’s work on the Standard Occupational Classification. These issues may appear technical, but they can shape access, reimbursement, recognition and the standards that support care.

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State policy can affect patient care more directly because it often defines licensure requirements and who may perform medical imaging and radiation therapy procedures. ASRT responded to proposals that would loosen licensure requirements in multiple states. ASRT also advised states updating laws governing the practice of medical imaging and radiation therapy, emphasizing guardrails that support safe, high-quality patient care and professional standards. In Georgia and Louisiana, radiologist assistant licensure efforts succeeded after work by volunteers and staff. THE VOICE BEHIND THE WORK In fiscal year 2026, ASRT tracked 221 legislative, regulatory and advocacy measures, including 210 state measures and 11 federal measures. The Society sent 6,131 state Take Action emails and more than 310,000 federal Take Action emails to ASRT members. Those figures show the breadth of the policy environment ASRT monitors and the role members play when policymakers need to hear from the profession. The volume of work shows why this kind of review cannot happen only after a proposal becomes urgent. Member voices matter because they connect policy language to daily practice. Advocacy depends on people who can explain how a proposal would affect patients, workflow and professional accountability. ASRT continued building that capacity in 2026 through programs such as

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Ambassadors for R.T. Advocacy, Engaging New Technologists and the ASRT Advocacy Training Program. These programs help radiologic technologists, radiation therapists and students understand how policy decisions affect patient care and professional practice. PROFESSIONAL RESPONSIBILITY For members, this work can feel far removed from the examination room or treatment area. Licensure language, reimbursement policy, education standards and scopeof-practice discussions shape who performs procedures, how roles are recognized, what standards apply and how patient care is delivered. Patient care must remain the anchor. Day to day, advocacy may involve responding to a bill, reviewing regulatory language or preparing for the next policy cycle. Taken together, those actions help keep the focus where it belongs: on whether the people performing medical imaging and radiation therapy procedures have the education, competency, supervision and accountability to provide safe, high-quality patient care. • Meredith Check, M.P.P., is ASRT director of government relations and public policy. Professionals interested in learning more about ASRT advocacy initiatives and resources can visit asrt.org/Advocacy.

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THE BYSTANDER EFFECT AT WORK: WHEN EVERYONE SEES IT, BUT NO ONE STEPS IN

he comment was inappropriate, and everyone in the room knew it. A senior technologist mocked a coworker’s accent during morning huddle. One person looked down. Another gave an uncomfortable smile. Someone changed the subject. The manager heard the exchange but decided not to make the situation bigger. No one agreed with the behavior, yet no one interrupted it. This is the bystander effect in the workplace: the tendency to remain passive when other people are present, often because we assume someone else will respond, question whether the situation is serious enough or worry that speaking up will create conflict. In imaging departments, this silence can allow workplace bullying, harassment, intimidation, discrimination and disrespect to become part of the culture. WHY GOOD EMPLOYEES STAY SILENT Employees do not always stay quiet because they approve of what happened. Many are calculating the personal cost of responding. They may wonder: Will I make this awkward? Will they say I am too sensitive? What if the person turns on me next? Is it really my place to say something? Introverted employees may struggle to find words quickly. New employees may fear damaging their reputation. Others may feel embarrassed speaking in front of a group or worry that intervention will escalate the situation. When leaders tell employees to “speak up” without showing them how, they place the entire burden on the person witnessing the behavior. SILENCE SENDS A MESSAGE When inappropriate conduct goes unchallenged, the targeted employee receives one message: You are on your own. The person responsible receives another: No one is going to stop me. The rest of the team learns to protect themselves by

ICEMAGAZINE | OCTOBER 2026

staying quiet. Over time, employees may stop reporting concerns, withdraw from conversations, avoid certain coworkers or leave the department entirely. The effects can extend beyond morale. A team that is afraid to challenge disrespect may also hesitate to question an unsafe protocol, report a near miss or address a breakdown in patient care.

DIRECTOR’S CUT BY DR. NICOLE DHANRAJ

HOW TO INTERVENE Managers do not need a perfect speech. They need to make it clear that they noticed the behavior and will not ignore it. A realistic response may be: “Let’s not make comments like that.” “That wasn’t necessary. Let’s move on.” “Hold on. Give her a chance to finish.” “We can disagree without speaking to each other that way.” The manager can then follow up privately: “I heard the comment you made during huddle. It put your coworker in an uncomfortable position, and it is not how I expect people to communicate here.” Managers should also check in with the affected employee rather than assuming the situation has passed. “I noticed what happened earlier. Are you OK? I am going to address it.” That brief acknowledgment can prevent someone from feeling invisible. TRAIN STAFF TO USE SMALL INTERVENTIONS Employees should know that intervening does not always require confrontation. They can interrupt the moment, redirect the conversation, support the person afterward, document what occurred or report the pattern to leadership. Useful phrases include: “Let’s give him a chance to explain.”

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“I don’t think that came across the way you intended.” “That joke is making this uncomfortable.” “Are you OK? I saw what happened.” Managers can practice these responses during staff training so employees do not have to invent the words while under pressure. The goal is not to turn every employee into a confrontational person. It is to build a department where people know they can act without being shamed for speaking up. The next time something inappropriate happens, your team will watch what leadership does. Will silence protect the behavior, or will someone make it clear that this is not who you are as a department? Let’s continue building workplaces where people feel safe, respected and supported, together. If your imaging department wants to strengthen psychologE R Osafety, M NRAE L O T N A C S communication and bystander interical respectful vention skills, I offer customized training for managers and healthcare teams. Sessions include realistic workplace scenarios and practical language employees can use without feeling confrontational or embarrassed. S•T N E M E E R G A E C I V R E S

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KEEPING PACE WITH AN EVOLVING IMAGING SERVICE INDUSTRY

edical imaging technology continues to advance at a remarkable pace. New platforms offer greater speed, precision and diagnostic capability, but they also create increasingly complex service challenges for the engineers responsible for maintaining them. For imaging service professionals, staying current requires more than learning how a system operates at a single point in time. Equipment configurations, software versions and service requirements continually change. Engineers need a combination of practical training, reliable technical information and experienced support to make informed decisions in the field. TRAINING FOR REAL-WORLD CONDITIONS In 2026, RSTI expanded its curriculum to include several newer and increasingly relevant imaging platforms, including Siemens Axiom Artis Q/Zee, Siemens SOMATOM Force CT, GE MRI, Philips Azurion, GE Pristina Mammography and Siemens MAMMOMAT Revelation. Developing effective training for these systems involves far more than creating a presentation. It requires acquiring and installing equipment, building a comprehensive curriculum, developing meaningful laboratory exercises and applying the insight of professionals with field-service experience. 40

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That hands-on component is essential because imaging engineers rarely encounter problems under perfect conditions. They work with different system configurations, equipment histories, software levels and operating environments. Effective technical education must go beyond theory and help engineers develop the judgment to evaluate the complete situation. TURNING SERVICE EXPERIENCE INTO USABLE KNOWLEDGE Classroom training provides a critical foundation, but technical learning does not end when a course is completed. Once engineers return to the field, they need dependable resources that help them apply what they have learned to situations that may not match a textbook example. RSTI developed and launched Sherlog, a technical support software platform designed to connect practical service information with access to experienced engineering support. Sherlog is now available to students and customers as an in-house-developed, AI-powered platform designed to help imaging service engineers troubleshoot more efficiently. It brings together searchable technical data, equipment error logs, documented service experiences and validated resolutions, providing quicker access to relevant information when challenges arise in the field. Engineers can pull and send equipment error logs without requiring the imaging system to be connected to a net-

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MROpen EVO The only real upright and multiposition MRI system. work – an important advantage when servicing equipment in environments with limited or restricted connectivity. Developed with ongoing input from experienced engineers, Sherlog will continue to expand and improve as imaging equipment, software versions and service needs change – not to replace engineering judgment, but to strengthen it with organized, reliable and experience-based resources. This type of resource can help turn individual service experiences into useful, accessible knowledge. Equipment error logs, documented support calls, troubleshooting processes and confirmed resolutions can create a valuable technical history, helping engineers build upon prior experience instead of beginning every service case from the same starting point. Information alone, however, is not enough. The same error may have different causes depending on equipment configuration, software level, service history or related system behavior. Technical data must be considered within the full context of the system. That is why experienced engineers remain essential. Technology can organize information, improve access and reveal patterns, but qualified professionals must give that information meaning. The goal is not to replace an engineer’s knowledge or judgment; it is to strengthen both with credible, experience-based resources.

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PRESERVING KNOWLEDGE FOR THE NEXT GENERATION Connecting education with ongoing field support also addresses a broader industry concern: the loss of institutional knowledge as experienced professionals retire. Decades of expertise can disappear when it remains confined to one person, one support call or one organization. Capturing, organizing and validating that knowledge helps make it available to the next generation of imaging service professionals. It can also support more consistent troubleshooting and create a stronger connection between formal training and day-to-day service work. The importance of strong technical education was also reflected in the 2026 TechNation Tech Choice Awards, where RSTI President Todd Boyland was named Educator of the Year. The peer-nominated and industry-voted recognition highlights the lasting value of educators committed to preparing and supporting imaging service professionals. As the industry looks toward 2027, imaging technology will continue to advance – and the way professionals learn, troubleshoot and share knowledge must advance with it. Hands-on education, continuously improving technical resources and experienced engineering judgment will all play an important role in preparing the imaging service community for what comes next.

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INSIGHTS

INTELLIGENT DIAGNOSTIC CHAIN:

RESHAPING RADIOLOGIST WORKFLOW

T PACS/IT/AI

BY MARK WATTS

he year 2026 finds the radiology department at a critical juncture. As a radiology professional, I have witnessed firsthand how the sheer velocity of imaging demand threatens to outpace the human capacity for nuanced interpretation. The persistent challenge of cognitive overload, the phenomenon where decision fatigue and high-stakes pressure degrade diagnostic accuracy, is no longer a theoretical concern; it is a clinical reality that demands a structural response. To move beyond the limitations of legacy computer-aided detection (CAD), we must shift our perspective. AI should not be viewed as a standalone utility, but as a deliberate, integrated layer across the entire medical imaging value chain. By embedding intelligent agents from the moment of acquisition through to the final retrospective audit, we can effectively protect the reader’s cognitive bandwidth and recenter the radiologist as the ultimate architect of diagnostic value. The journey begins at the acquisition phase, long before an image reaches the radiologist’s display. Implementing autonomous quality control checks at the technologist’s console ensures that technical errors – such as motion artifacts, suboptimal contrast bolus timing in CT pulmonary embolism studies or the malposition of life-critical hardware like endotracheal tubes – are caught at the source. By resolving these technical deficits before the patient leaves the department, we eliminate the downstream inefficiency of recalled exams and repeat scans. This foundational layer of intelligence acts as a silent but effective gatekeeper, ensuring that the radiologist is

ICEMAGAZINE | OCTOBER 2026

never burdened with interpreting suboptimal or misleading data. For the non-radiologist clinician, particularly in urgent and emergency settings, AI serves as an indispensable safety net. In scenarios such as a primary care physician evaluating a chest radiograph for a suspected pneumothorax or a trauma team assessing cervical spine alignment in an MVA patient, rapid AI-driven triage provides immediate clinical clarity. When properly designed, these tools do not replace the clinician’s judgment but provide an auxiliary layer of protection, preventing missed acute findings in high pressure environments. By clearly watermarking these preliminary reads as assistive, we empower multidisciplinary teams to make time-sensitive stabilization decisions with greater confidence. As studies reach the radiologist’s worklist, intelligent orchestration takes the helm. Through advanced triage algorithms, we can dynamically sort cases based on both clinical acuity and pixel-level evidence, ensuring that true stat studies rise to the top while automatically filtering out incorrectly labeled priority levels. This reduces the chaos of an undifferentiated worklist and protects the reader from the relentless background noise of alert fatigue. Within the interpretation workspace, the “second set of eyes” must evolve from a passive overlay to a collaborative copilot. By presenting findings as a curated, unweighted multiple-choice differential, reminiscent of modern mammographic CAD but applied broadly, we force active cognitive engagement. This approach mitigates the risk of automation bias, as the radiologist is prompted to consciously evaluate alternative possibilities rather than falling prey to the complacency of accepting a single machine asserted outcome.

ADVANCING THE IMAGING PROFESSIONAL

Efficiency in the report phase is further amplified by longitudinal harmonization. Before the radiologist even begins dictation, agentic systems can perform automated image registration, aligning current datasets with historical studies to generate a quantitative change map. This feature drastically accelerates the comparison process, allowing the reader to focus on pathology rather than the manual effort of hunting through archived scans. Simultaneously, integrating imaging findings with unstructured EHR data, such as laboratory results, pathology reports and clinical notes, provides the reader with a holistic patient brief. This context-aware synthesis ensures that interpretation is deeply informed by the patient’s clinical journey, effectively closing the gap between the isolated imaging study and the broader therapeutic strategy. Beyond the initial report, we must leverage AI to bridge communication gaps and ensure institutional accountability. When critical findings like aortic dissection or large vessel occlusion are detected, the system can trigger immediate, targeted alerts to cardiovascular or neurological specialists, complete with embedded visual snippets. This real-time coordination of care significantly reduces door-to-intervention times. Furthermore, the value chain extends into the postreading phase, where AI performs retrospective quality assurance. By auditing completed reports against CPT codes and clinical documentation, these systems identify missed billing opportunities or discrepancies in charge capture. This does not merely optimize hospital reimbursement; it provides an

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objective, data-driven feedback loop for departmental quality improvement and longitudinal skill development. Finally, we must recognize the potential for AI to serve as a bridge to the patient. By translating complex, jargon-heavy reports into plain-language summaries supported by interactive 3D visualizations, we foster patient literacy and empowerment. This transparency, managed under the guidance of the ordering clinician, fulfills the mandate for patient-centered care and eases the anxiety often associated with waiting for diagnostic results. As we look toward the future of radiology, the goal of these informatics strategies remains consistent: to enhance, rather than replace, the human expert. By weaving AI into every link of the imaging value chain, we create a workflow that is resilient, accurate and deeply attuned to the realities of clinical practice in 2026. This is not about the wholesale automation of medicine, but the strategic augmentation of the radiologist, a partnership where artificial intelligence manages cognitive load, allowing the human physician to focus on interpretation, consultation and compassionate care that define our specialty. By embracing this holistic approach, we ensure that the next generation of radiologists is not defined by burnout, but by their ability to provide the highest standard of diagnostic precision in a rapidly evolving clinical ecosystem. • Mark Watts is an experienced imaging professional who founded an AI company called Zenlike.ai.

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INSIGHTS

MANAGERS: STOP SOLVING EVERY PROBLEM

I EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI

ICEMAGAZINE | OCTOBER 2026

magine a manager being stopped by a technician about a problem. After 30 seconds, the manager knows exactly what to do, because he spent years doing the same technical job before being promoted. With just a few questions he confirms the problem, then gives the technician an answer and heads to his office. Once there he receives several important phone calls followed by an urgent email. This pace continues, and by the end of the day he’s barely touched the work he planned to do. This kind of day is common for managers who come up through technical professions. Why? Because they get promoted due to being good at getting things done. They excel at diagnosing problems, finding answers, fixing what’s not working and moving on to the next challenge. Unfortunately, after getting promoted to management, the habits that made them successful at the technical level are hard to leave behind. This explains why research shows managers spend nearly 40% of their time resolving immediate problems but only 13% of their time developing their people. This should not be.

When a technical expert is promoted to management, they’re at a new level in the organization. That requires not only a new level of thinking, but also a new set of behaviors. As managers, one of their new responsibilities is developing people to be able to solve problems without them. Think of it this way. If you’re a new manager with the answers everyone needs before moving forward, you’re not creating a team, you’re creating dependence. The problem? Dependence can look an awful lot like good management. People come to you because you get problems solved and projects move forward. Your calendar is packed, your phone never stops ringing and you’re seen as indispensable. Why is that a problem? Because one of a manager’s primary responsibilities is to create capabilities in other people. Research by the Gallup organization over the past few years has found the following among American workplaces: • Only 31% strongly agreed that someone at work encouraged their development • Only 32% felt strongly connected to their organization’s mission and purpose • Just 28% strongly agreed their opinions counted at work

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HOW TO DEVELOP YOUR TEAM If you’re a manager and you’d like to be better at developing your team, here’s a suggestion: Stop answering every question. In other words, the next time someone brings you a problem, resist the urge to demonstrate how quickly you can solve it. Instead, try asking, “What do you think we should do?” At first you may get a blank stare, but that’s OK. Drill down by asking what they think is causing the problem, what they’ve already tried and what options they see. Another question you might ask is, “If I weren’t here, what would you do?” The point isn’t to play a game of managerial 20 questions. If employees don’t have the knowledge or experience to make the decision, that becomes an opportunity for training, not an opportunity for you to look good by providing an answer. One of my clients had the habit of answering every question that came his way. It made him feel important, but whenever he left the office for even a few days, problems backed up and he was slammed when he returned. Why? Because his people had learned to depend on him instead of making decisions themselves. The two of us discussed ways he could ask questions instead of answering them. It worked. Later in our coaching relationship he said, “You’ll be proud of me. I haven’t made a decision in over a month.” Taken out of context that could sound like an admission from a lazy manager, but I knew exactly what he meant. By asking his direct reports to diagnose problems and having them recommend solutions, he taught them to become self-sufficient. After that, when he left the office for a week, his workplace hummed along like a finely tuned machine. Does this growth process flow smoothly? No. Developing people requires some tolerance for imperfection. Your employees may not solve problems exactly the way you would. They may choose option B when you might have chosen option A. One key to succeeding in such situations is to ask yourself a simple question: Does it matter? In other words, if both roads solve the problem safely and get you to the right destination, does it matter if the employee doesn’t do the exact thing you would do?

I’m not suggesting you lower your standards or accept inferior work. I’m talking about cooperatively defining success and giving people room to operate within that definition. WHY DEVELOPING PEOPLE MATTERS For managers, taking the time to empower direct reports is vital because the workplace isn’t getting simpler. In a recent study from Deloitte, one of the world’s largest business consulting and professional services firms, one-third of workers surveyed experienced 15 major changes in a single year. That’s a big number. No manager can oversee that much change and continue dispensing the right answer for every situation employees encounter. Organizations need people throughout the workforce who can think, decide and act. Managers help create those employees by providing clear expectations, asking good questions and resisting the urge to personally solve every problem that lands on their desk. This brings us back to our manager walking down the hallway. Imagine it’s three months later and the same technician stops him with another problem. Once again, the manager has a pretty good idea what the answer is, but this time he asks a question the technician has heard many times before: “What do you think we should do?” The technician is ready for it. He suggests two possible solutions, lists the pros and cons of each, and recommends an action. The manager thinks about it for a second and says, “Sounds good. Make it happen.” Bottom line, it’s healthy when a manager empowers his or her people to take responsibility for their work. Investing time to develop team members is time well spent. •

Organizations need people throughout the workforce who can think, decide and act. Managers help create those employees by providing clear expectations, asking good questions and resisting the urge to personally solve every problem that lands on their desk.

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Daniel Bobinski has a doctorate in theology and is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him by email at DanielBobinski@protonmail.com or 208-649-6400.

ICEMAGAZINE

INSIGHTS

OTHERING IN THE WORKPLACE: WHAT IMAGING MANAGERS NEED TO RECOGNIZE

n employee can wear the same badge, attend the same huddles, and cover the same call schedule as everyone else, yet still leave work wondering, “Do these people actually see me as part of the team?” That experience has a name: othering. Othering occurs when a person or group is treated as different from the people considered accepted, trusted or influential. It may be connected to race, culture, gender, age, disability, religion, military status, accent, education or sexual orientation. In imaging departments, it can also develop around job roles and workplace status: day shift versus night shift, permanent staff versus travelers, experienced technologists versus new graduates, or one modality versus another. Othering is not always loud. Sometimes it is a joke, an eye roll, an inside conversation or a decision made without certain team members in the room. WHAT OTHERING LOOKS LIKE IN AN IMAGING DEPARTMENT I have seen versions of this situation play out in imaging departments. A recently hired technologist questioned whether the correct protocol had been selected for a patient. Before the technologist could finish, a senior employee sighed and said, “We have been doing this a long time. You are not at your old hospital anymore.” A few coworkers laughed. The manager heard the exchange but continued walking. The examination moved forward. The technologist never mentioned the concern again. The comment lasted only a few seconds. The impact lasted much longer. She learned that asking questions could lead to embarrassment. The senior employee learned that dismissing her was acceptable. The rest of the team learned that silence was safer than challenging the group. That is when othering becomes more than a workplace culture issue. It becomes a psychological safety, employee retention and patient safety issue.

ICEMAGAZINE | OCTOBER 2026

DEI BY DR. NICOLE DHANRAJ

WHY OTHERING IS A MANAGEMENT RESPONSIBILITY Employees who feel excluded often begin making themselves smaller. They stop contributing during meetings. They hesitate to ask for help. They may avoid reporting a near miss because they do not want to be labeled inexperienced, difficult or overly sensitive. Eventually, some disengage. Others leave. Imaging managers should notice who receives informal coaching, desirable assignments, schedule flexibility, training opportunities, recognition and access to leadership. Othering is not only reflected in what people say. It is also revealed through patterns of opportunity. HOW MANAGERS CAN INTERRUPT OTHERING Managers do not need a polished speech. They need the confidence to interrupt the moment. In the earlier situation, the manager could simply say: “Hold on. Let her finish.” Then: “That’s a fair question. Let’s double-check the protocol.” Later, the manager could speak privately with the senior employee: “I noticed how you responded when she asked about the protocol. You may not have meant anything by it, but shutting people down makes them less likely to speak up. I need you to handle those questions differently.” One practical step managers can take today is to watch the next team meeting closely. Who speaks freely? Who is interrupted? Whose ideas receive attention? Who has learned to remain quiet? Inclusive leadership begins with noticing. Look around your imaging department. Who shows up, does the work and still wonders whether they truly belong? If your imaging department is working to strengthen psychological safety, belonging and team communication, I can help! • Dr. Nicole Dhanraj is out to make a difference, and values our workforce for what they bring, if you want to chat on this topic more or share your insights, do reach out nicoledhanraj@gmail.com. ADVANCING THE IMAGING PROFESSIONAL

MEDICINE FOR THE SOUL

9 STEPS FOR A LIFETIME OF HEART-HEALTHY EATING BY FEATURE IMPACT

ore than half of adults and about 60% of children in the United States have unhealthy diets, which can contribute to higher rates of health factors such as high blood pressure and obesity, and lead directly to poor health outcomes including death from chronic conditions such as cardiovascular disease. These findings come from the American Heart Association, a global force changing the future of health for all, which published its “2026 Dietary Guidance to Improve Cardiovascular Health” in its peer-reviewed, flagship journal “Circulation” recommending Americans follow a lifelong healthy eating pattern that may reduce cardiovascular disease risk and improve quality of life based on the latest in evidence-based science. The statement outlines nine key features of a hearthealthy dietary pattern: 1. Adjust energy intake and expenditure to achieve and maintain a healthy body weight: Try to balance how much you eat with how active you are to reach and maintain a healthy body weight. 2. Eat a variety of vegetables and fruits: Include different colors, textures and types of produce. Remember, even canned and frozen can be nutritious and affordable. 3. Choose foods made mostly with whole grains: Foods such as whole‑wheat bread, brown rice and oatmeal are typically better choices than refined grains including white bread or rice. 4. Choose healthy sources of protein: Shift from meat to plant-based sources such as legumes, including beans, peas and lentils, along with nuts and seeds; regularly consume fish and seafood; select low-fat or fat-free dairy products; and, if red meat is desired, choose lean cuts, avoid processed forms and limit portion size. 5. Choose sources of unsaturated fats: Replace saturated fats with healthy unsaturated fats, including those from nuts, seeds, avocados and nontropical plant oils. THEICECOMMUNITY.COM

6. Choose minimally processed foods: Go with foods close to their natural state, with minimal added commercial ingredients, rather than those that are highly processed with additives. 7. Minimize intake of added sugars: Limit the sugar-sweetened beverages you drink and the foods with added sugar you eat. 8. Choose foods low in sodium and prepare foods with minimal or no salt: Be aware of hidden sources of sodium in prepared and packaged foods, and season food with healthier options such as herbs, spices or lemon instead of salt. 9. If alcohol is not consumed, do not start; if alcohol is consumed, limit intake: Alcohol can increase your risk for high blood pressure and other health conditions, so if you don’t drink, don’t start. “For healthy eating to be more attainable and sustainable, we recommend people focus on their overall eating pattern rather than specific nutrients or foods,” said Alice H. Lichtenstein, D.Sc., FAHA, volunteer chair of the scientific statement writing committee and senior scientist and leader of the Diet and Chronic Disease Prevention Directive at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. “Every time you choose to make a swap for a healthier alternative, you’re making a step toward a healthier life.” While the updated guidance is specifically designed to improve cardiovascular health, it’s generally consistent with dietary recommendations for other conditions like Type 2 diabetes, kidney disease, some cancers and brain health as well due to shared risk factors, including high blood pressure, high cholesterol, high blood sugar, excess weight and reduced kidney function. “A healthy dietary pattern can support lifelong health and well-being beyond cardiovascular health,” Lichtenstein said. • To learn more about eating for heart and brain health, visit heart.org/healthydiet and talk to your health care provider about what will work best for you. ICEMAGAZINE

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