A strong research question can still fail if the study design cannot answer it. Michael Soulen, MD, and Shudaveep Ganguly, MD, DM, speak with host Amit Gupta, MD, about selecting meaningful outcomes, matching design to the question, avoiding pitfalls of diagnostic accuracy studies, involving statisticians early, and building multidisciplinary trials. Listen to their discussion in episode 3 of The Early Career Researcher's Playbook, an AJR Podcast Series.

*Key Takeaways

Meaningful Outcomes vs. Surrogates: Technical success and progression-free survival are only surrogate endpoints. Patients and clinicians ultimately care about overall survival and quality of life. Imaging surrogates are notoriously poor predictors of true clinical benefit.

Flaws in Diagnostic Accuracy: Relying purely on sensitivity and specificity is problematic if the study population doesn't reflect real-world conditions. Likelihood ratios may provide a realistic indication of a test's clinical impact.

Early Statistical Integration: Never treat a statistician as a data calculator at the end of a study. Engaging them during the brainstorming phase ensures feasibility and helps to properly structures your protocol and database.

*Chapters

0:00 - Welcome

2:23 - Choosing Meaningful Outcomes

9:28 - RCTs and Real World Limits

18:36 - Diagnostic Study Pitfalls

25:58 - From Accuracy to Impact

28:55 - Statistics Starts Early

37:45 - Making Collaboration Work

47:01 - Quick Fire Playbook

51:04 - Final Advice

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

Threads: https://www.threads.com/@ajr_radiology

*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

How can AI help predict breast cancer risk? Heta Ladumor, MD, discusses the AJR article by Xu et al. that developed a novel deep-learning tool for predicting risk from DBT examinations.

Full article: Predicting 5-Year Breast Cancer Risk From Longitudinal Digital Breast Tomosynthesis: A Single-Center Retrospective Study

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

Neuroimaging utilization in the emergency department (ED) is growing. Christopher Ruggiero, MD, discusses this article by Rai et al. that explores this growth in over 3 million ED encounters nationally.

Full article: Utilization of Emergency Department (ED) Neuroimaging From 2016 to 2025: Analysis in Over 3 Million ED Encounters from the Multicenter Cosmos EHR Dataset

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

Vision language models (VLMs) are receiving growing attention in radiology. Kathy Dai, MD, is joined by Dorothy Sippo, MD, MPH, to discuss the article by He et al. exploring the use of VLMs for axillary lymph node assessment in patients with breast cancer.

Full article: Vision Language Models for Ultrasound Assessment of Suspicious Axillary Lymph Nodes in Breast Cancer

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

What happens when the system goes down in a cyberattack? Ichiro Ikuta, MD, MMSc, speaks with cohosts Lindsey Negrete, MD, and Amy Maduram, MD about real-world vulnerabilities and consequences of cyberattacks in radiology. Listen to their discussion in episode 3 of Extreme Radiology, an AJR Podcast Series.

https://www.ajronline.org/doi/10.2214/AJR.26.35847

*Key Takeaways

The Power Dynamics of Phishing: Hackers may impersonate department chairs or hospital CEOs using spoofed emails to pressure staff into handing over login credentials. Always verify suspicious requests via a direct phone call or in-person conversation.

The Threat of Outside CDs: Discs containing outside imaging studies are major vectors for malware. To help prevent spreading a digital infection, outside CDs should be uploaded in isolated, dedicated environments rather than directly on standard clinical workstations.

AI and Blockchain in Cybersecurity: While blockchain technology offers decentralized tracking to protect financial and patient data, artificial intelligence is a double-edged sword, equipping both cybersecurity defenders and malicious hackers with significantly more powerful tools.

*Chapters

0:00 - Opening

2:07 - Why Cybersecurity Matters

4:15 - How Hospitals Get Hacked

8:31 - Spotting Phishing Tricks

11:24 - When Systems Go Down

14:40 - Legal Duties and Training

16:25 - Recovery and Backlog Reality

20:01 - AI and Blockchain Threats

22:39 - Can You Hack It? Game

27:32 - Radiology Targets and Defenses

30:05 - Wrapping Things Up

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

The radiologist shortage is real, and international medical graduates (IMGs) are already helping solve it. Sohrab Afshari Mirak, MD, speaks with cohosts Surbhi Raichandani, MD, and Sherry Wang, MBBS, about his path from Tehran to UCLA, the American Board of Radiology Alternate Pathway, visa hurdles, and what IMGs bring to patient care. Listen to their discussion in episode 3 of Difficult Conversations, an AJR Podcast Series.

*Key Takeaways

Beyond the Step Score: Residency programs should not filter IMG applicants based on USMLE scores or graduation gaps; letters of recommendation and other application components offer additional important information. The ABR Alternate Pathway: Recent changes by the American Board of Radiology now allow internationally trained radiologists to complete their four required fellowship years non-consecutively within an eight-year window, significantly reducing a source of uncertainty. Clinical Diversity: IMGs bring unique proficiencies and skill sets developed in healthcare systems with workflows that differ from in the United States.

*Chapters

0:00 - Welcome and Intro 0:54 - Impact of Radiologist Shortage 3:43 - Dr. Mirak's IMG Journey 6:07 - Residency Screening Pitfalls 10:02 - Letters and Observerships 12:14 - Research and Networking Tips 15:21 - ABR Alternate Pathway 18:52 - Visa Choices and Waivers 25:44 - Cultural Support for IMGs 28:38 - Global Models and IMG Value 35:56 - One Policy Change 38:05 - Closing Thoughts

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

Good research questions may be hiding in everyday clinical work. Marco Francone, MD, PhD, and Daniel Pinto dos Santos, MD, speak with host Amit Gupta, MD, about transforming clinical intuition, recurring gaps, and diagnostic challenges into focused, testable, and clinically impactful research. Listen to their discussion in episode 2 of The Early-Career Researcher's Playbook, an AJR Podcast Series.

https://www.ajronline.org/doi/10.2214/AJR.26.35769

*Key Takeaways

Questioning the Routine: Meaningful research often begins by simply asking "why" established practices exist. For example, questioning the necessity of a non-contrast series prior to contrast media administration when looking for abdominal hemorrhage may lead to a publishable study. The Prospective Shift: Retrospective research may be limited by biased intuitions and imperfect hypotheses. The specialty should move toward prospective models, carefully considering the clinical impact and cost-effectiveness of potential interventions. The "Tool-First" Trap: Pushed by a publish-or-perish academic culture, researchers may make the mistake of starting with an AI model or radiomics pipeline and then searching for a problem to which to apply it. True clinical impact more likely comes with starting with the patient problem and finding the appropriate method to solve it. Combating Confirmation Bias: When researchers firmly believe their own clinical intuition, they risk designing studies solely to confirm their preconceived notions. To maintain scientific credibility, you should assign a colleague the specific role of opposing your views to actively try and prove your hypothesis wrong.

*Chapters

0:00 - Introduction

2:07 - What Clinical Intuition Means

6:47 - Daniel's Routine to Research

9:23 - Ideas Hiding in Workflow

11:32 - From Observation to Study Plan

14:28 - Marco's Prospective CT Example

18:26 - Avoiding Confirmation Bias

23:20 - AI Tool First Trap

29:53 - Quick Fire Takeaways

33:34 - Final Advice and Closing

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

Threads: https://www.threads.com/@ajr_radiology

*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

How fast can a knee MRI examination be performed? Zahra F. Rahmatullah, MBBS, discussed the article by Leonhardt et al. exploring a deep-learning pipeline for achieving 7-minute knee MRI.

Full article: Arthroscopy-Validated Diagnostic Performance of a Deep Learning Reconstruction Pipeline for Rapid 7-Minute Five-Sequence 3-T Knee MRI

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

In-stent restenosis presents a challenge on coronary CTA. Bryce Saba, MD, discusses the multicenter study by Xu et al. exploring a super-resolution deep-learning reconstruction method for stent evaluation.

Full article: Comparison of Super-Resolution Deep-Learning Reconstruction and Hybrid Iterative Reconstruction for Coronary Stent Assessment on CTA: A Prospective Multicenter Study

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

Could you handle the high-stakes pressure of working with professional athletes? Chris Beaulieu, MD, PhD, speaks with co-hosts Lindsey Negrete, MD and Amy Maduram, MD about the medical, legal, and communication challenges involved when dealing with a professional sports franchise. Listen to their discussion in episode 2 of Extreme Radiology, an AJR Podcast Series.

https://www.ajronline.org/doi/10.2214/AJR.26.35724

*Key Takeaways

The Monday Morning Rush: While game-day X-rays are typically read by team orthopedists at the stadium, the radiologist's critical role begins on Monday morning with reserved MRI slots to accurately stage and grade joint injuries.

Call it Tight, But Call it Right: Radiologists should avoid overcalling minor, non-acute incidental findings, such as mild degenerative changes, that could needlessly trigger panic.

Controlling the Narrative: Direct communication with players, coaches, or sports agents is highly discouraged due to the risk of misinterpretation. Radiologists maintain a strict reporting chain directly to the head athletic trainer and team orthopedic surgeon.

Astronomical Liability: The malpractice risk in pro sports imaging operates on a vastly different scale, with potential liability reaching hundreds of millions of dollars to cover an athlete's lost career wages.

Second Opinions: Because most sports injuries are non-surgical and imaging serves as the gold standard, agents frequently demand multiple opinions.

*Chapters

0:00 - Welcome

4:15 - Game Day Imaging Setup

5:34 - Monday Morning MRI Rush

7:48 - Stadium PACS And Teamwork

9:47 - Communication With Players

11:30 - Pressure And Liability

13:50 - Reporting Nuance And Contracts

19:53 - Ultrasound-Guided Interventions

22:18 - Call It Tight. Call It Right.

27:51 - Monday Morning Quarterback Game

40:06 - Closing

Follow AJR on Social Media

LinkedIn: https://www.linkedin.com/showcase/ajr-radiology/

YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg

Instagram: https://www.instagram.com/ajr_radiology/

TikTok: https://www.tiktok.com/@ajr_radiology

X: https://x.com/AJR_Radiology

BlueSky: https://bsky.app/profile/ajrradiology.bsky.social

Threads: https://www.threads.com/@ajr_radiology

*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.