Sponsored by AllParts Medical
As computed tomography (CT) technology continues to evolve, imaging leaders are balancing the promise of artificial intelligence (AI), advanced reconstruction techniques and workflow automation with the practical realities of clinical care. For this Director’s Circle article, ICE Magazine spoke with imaging executives from leading health systems about the innovations shaping CT operations today, from image quality improvements and dose optimization to protocol standardization and productivity gains. Their insights highlight how organizations are leveraging emerging technologies to enhance diagnostic confidence, support staff efficiency and prepare for the future of medical imaging.
• Hartford Healthcare CT Scan Radiology Manager Hartford Region Bridget Hill;
• Madison Memorial Hospital Radiology Manager Robbie Burch;
• Ohio State University Wexner Medical Center Associate Director Hospital Imaging Amy Rupe;
• Ohio State University Wexner Medical Center Imaging Quality Specialist-CT Andrea Tschirner; and
• UT Southwestern University Hospital Operations Manager Kristi Schkade.
Q: What are the biggest trends you are currently seeing in CT imaging technology?
HILL: From what I am seeing in CT, many of the advancements are focused on improving both image quality and workflow efficiency. Some of the biggest trends include increased automation, faster rotation times, motion-correction technology, auto-centering and patient positioning, remote scanning capabilities, dual-energy imaging, and photon-counting CT. These innovations are helping departments improve consistency, increase throughput and enhance patient care.
BURCH: One of the trends I see is that CT imaging is continuing to be the modality of choice in regard to emergency medicine. ER physicians need quick results, and CT provides those results quickly with a lot of critical information. Another trend I see is CT scanner manufacturers developing technology that helps speed up the scan process while decreasing the patient dose. I believe a lot of the imaging technology being developed is really geared towards CT scans for accurate patient diagnoses and outcomes.
TSCHIRNER: The increased utilization of dual energy is currently a trend we are looking to expand on in our organization. This is a collaboration of radiologists, ordering providers, education, research and protocol optimization.
SCHKADE: One of the biggest trends in CT imaging is the expansion of the technologist’s role. Technologists are increasingly taking on more clinical responsibility by selecting exam parameters based on patient indications and performing advanced studies such as cardiac CT, perfusion imaging and oncology exams. At the same time, the role is shifting from manual, task-based work to a more workflow-driven, efficiency-focused approach. With advancements in technology, processes like image reconstruction are becoming automated, allowing technologists to focus more on patient care, protocol optimization and overall exam quality.
Q: How has AI influenced CT operations at your organization?
HILL: In our organization, AI continues to make a meaningful impact in CT. We are seeing it help with neuro and cardiac imaging, identify critical findings and prioritize those exams for review, and improve the accuracy and consistency of post-processing. Overall, it has become a valuable tool for both workflow efficiency and clinical decision-making.
BURCH: AI has helped our CT scan times and patient throughput. Our CT scanner has smart positioning, and this helps scan accuracy and decreases patient positioning errors.
TSCHIRNER: We are currently utilizing AI-driven calcium scoring automation which identifies, labels and measures coronary calcium automatically and calculates Agatston score without manual tracing. This has been successful since its initiation and is still a work in progress and advances come with MESA scores. Key benefits have been: 10-minute time savings per case, reducing manual steps and errors, consistent results, workflow standardization, and automated routing to PACS/VNA.
SCHKADE: Ultimately, AI is redefining CT from a high-volume diagnostic workhorse into a more intelligent, efficient and data-driven modality by enhancing patient outcomes while strengthening overall departmental performance.
Q: What factors are most important when evaluating or purchasing a new CT scanner?
RUPE: In our organization, we approach CT equipment evaluation through a multidisciplinary team that includes providers, technologists, leadership, clinical engineering and medical physics. This ensures we’re aligning decisions with clinical needs, operational workflows and long-term strategy. When evaluating or purchasing a new CT scanner, the most important factors typically fall into several key areas: clinical capability and image quality; radiation dose and patient safety; workflow efficiency; integration with current systems; operational and site considerations; and future readiness and technology.
BURCH: Patient and staff safety is a priority. A scanner that uses lower radiation to acquire accurate and sharp images is important. A scanner that has AI technology that assists the technologists during the exams is also a priority. I also want the staff to understand the software quickly so they can perform the exams in a safe and effective manner.
SCHKADE: When evaluating a new CT scanner, image quality remains the foundation, driving diagnostic confidence and influencing every clinical decision. Equally important is the radiation dose delivered to patients, as balancing image quality with dose optimization remains a central priority. Beyond these fundamentals other practices to consider are the range of clinical applications including interventional and procedural capabilities. Technical specifications from detector design to reconstruction technology as they influence both performance and future scalability. Finally, speed and workflow play a critical role, affecting patient throughput, staffing productivity and overall patient experience.
Q: Photon-counting CT and spectral imaging continue to gain attention in the industry. What are your thoughts on these emerging technologies and their future clinical impact?
HILL: When evaluating new CT technology, I look for solutions that support cardiac and structural heart growth, deliver exceptional image quality, improve workflow and throughput, leverage automation and AI, integrate seamlessly with existing systems, and provide the reliability and service support needed for a high-volume 24/7 Level I trauma center. The systems technology and the engineering services are both crucial to image quality and the uptime of a scanner.
BURCH: It is very exciting! It is amazing what these technologies can provide for accurate patient diagnoses, such as stroke evaluation, blood clots and early tumor detection. Patients will also receive a lower radiation dose, without degrading the image quality. In fact, the images are sharper with less of a chance for image artifact.
TSCHIRNER: Innovation is an initiative we encourage and embrace at our organization, especially when it could provide a new standard of care that can lead to positive outcomes for our patients. The introduction of photon counting CT and its potential clinical benefits have been of interest to us and we currently have two photon-counting scanners at our organization. Potential benefits include higher spatial resolution, better contrast differentiation (especially vascular, cardiac, oncology), dose reduction, material decomposition, and improved low-contrast detectability in subtle lesions; to name a few. Use and optimization of photon counting has led to innovation and protocol creation (i.e., CT spinal cord compression evaluation), use of virtual monoenergetic imaging reconstructions for certain indications, and although we are early in our adoption planning, we look forward to the expansion of the possibilities.
SCHKADE: Photon-counting and spectral imaging are providing a more precise quantitative and even functional evaluation. Photon-counting CT delivers a higher spatial resolution and better signal to noise ratios. This allows radiologists to visualize fine structures with greater clarity. The advancement of photon-counting CT offers advanced precision, could allow for earlier detection and better monitoring of the disease over time.
Q: What are some of the biggest service and maintenance challenges associated with CT equipment today?
HILL: For our organization, some of the biggest service and maintenance challenges with our current equipment are related to the increasing complexity of CT technology. As scanners become more advanced, the calibrations, software upgrades and preventative maintenance activities often take longer and require greater technical expertise. The current global economic environment and supply chain constraints can also create challenges with parts availability and shipping, making it increasingly important to understand a vendor’s inventory strategy and service support model. In addition, our high-volume scanners experience significant wear and tear, particularly on X-ray tubes, which can lead to more frequent tube replacements over the life of the system. As we evaluate future equipment purchases, strong service support, parts availability, and overall uptime remain important considerations to ensure reliable patient care and operational efficiency.
BURCH: Probably the biggest challenge is unplanned downtimes. We make it a priority to stay up to date on all our preventative maintenance. We communicate with all the departments in the hospital when the CT scanner goes down for a PM. We want to make sure our CT scanner is always running to provide our community with the imaging service they require.
RUPE: One of the biggest challenges is managing downtime, especially when it’s tied to parts availability or delays in vendor support for complex repairs, which can limit how quickly issues are resolved. Coordinating planned maintenance without disrupting high patient volumes is another ongoing challenge, and we work to balance that based on time of day and outpatient schedules. Operationally, when multiple systems go down, it can significantly impact patient access. In those situations, we quickly shift patients across our system (often same day) to maintain continuity of care.
SCHKADE: Some of the most significant service and maintenance challenges include a shortage of field service engineers, which can delay troubleshooting and extend downtime. Additionally, diagnosing issues with complex systems often takes longer. Facilities are experiencing delays in replacement parts and in some cases, the parts that have arrived are defective or damaged, which prolongs the equipment outages.
This month’s article was sponsored by AllParts Medical. For more information on this company, visit allpartsmedical.com.
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