6 Bold Predictions for RSNA 2025 — What Radiologists Will Actually Be Talking About in Chicago

RSNA isn’t just a conference. It’s radiology’s annual reality check. This year’s focus on imaging the individual isn’t marketing language. It reflects the shift already happening in health systems: radiology is moving from “standard workflow” to “situational decision-making,” where the value of imaging is measured not just by accuracy, but by relevance, timing, and what it unlocks downstream.

RSNA 2025 won’t be defined by one flashy announcement. It will be defined by what the field decides no longer belongs — in the workflow, in the budget, or in the story radiology tells about itself.

Here’s what will actually matter:

1. Imaging moves from standard output to situational judgment.

Radiology has spent the last decade cleaning up variability. Standardized reporting. Protocol alignment. Quality dashboards. All important. But now the conversation is shifting. The question is no longer “Can we scan this?” It’s “What does this patient actually need, and what else can we extract from this image that we’re currently wasting?”

Opportunistic screening. Radiomics. Longitudinal image analysis. These aren’t research posters anymore. They’re being discussed in budget meetings because they create value without adding another study.

The challenge is no longer technology. It’s ownership. Who decides when a CT becomes more than a CT. Who manages the logic? Radiologist? Technologist? Software? And how much variation a “personalized” workflow can tolerate before throughput breaks.

Personalization is no longer hypothetical. But scaling it is far from solved.

2. AI stops selling potential and starts defending its place in the workday.

Radiologists are done grading AI on accuracy claims. The only real question now is: does it save time or cost time.

That’s why the AI Theater exists this year. Not to hype AI, but to separate what works from what sounds good. The companies that get attention won’t be the ones saying “first, only, breakthrough.” They’ll be the ones that fit inside the workflow, reduce clicks instead of adding more and have performance data after go-live.

If a tool makes the reading room slower, no one cares how impressive the model is. If it needs a separate screen, extra tab, or new checklist, it’s dead on arrival.

Real-world AI success criteria in 2025 are simple:

• Works inside PACS or reporting
• Doesn’t drift or disappear after install
• Doesn’t turn radiologists into IT managers
• Gives back time without asking for attention

No one is asking whether AI belongs. They’re asking whether it earns its seat.

3. Hardware innovation gets quieter and more relevant.

Yes, CT and MRI will be everywhere again. But not because vendors are pushing “biggest” or “fastest.” The real story is that scanners are finally being built for the realities of modern imaging: staff shortages, helium scarcity, energy cost, and patient throughput.

Fast MRI through reconstruction intelligence is no longer a demo video. Photon-counting CT isn’t future tense. Helium light magnets aren’t a science project, they’re a supply-chain hedge.

Capital planning conversations used to be: “How sharp is the image?” Now they’re: “How many more patients can we image with the same team, the same footprint, the same quality, and less lifetime cost?”

The headline isn’t hardware as a trophy. It’s hardware as a system that respects constraints.

4. The workforce crisis forces radiology to redesign work, not keep pretending more staffing is coming.

Everyone is dealing with the same math: more studies, fewer radiologists, growing burnout, shrinking patience for the phrase “we just have to push through.”

The departments adapting fastest are the ones that stopped treating this as a recruiting problem and started treating it as a workflow design problem. They are not asking how to hire more bodies. They are asking how to protect radiologist time for the work only radiologists can do.

That shows up as:

• smarter worklist routing
• APPs taking on structured, repeatable tasks
• AI handling the clerical and the obvious
• hybrid reading models by design, not desperation

RSNA won’t fix the shortage. But it will make one thing obvious: the winners won’t be the groups that hustle harder. They’ll be the ones that design around human limits.

5. Sustainability stops being “nice to have” and becomes a business decision.

Radiology has one of the highest environmental footprints inside the hospital. For years, that didn’t affect anything. Now it does, because sustainability has moved from PR to procurement.

Helium-light systems. Low-power standby modes. Cloud PACS to replace server rooms. These aren’t “green features.” They reduce risk, service cost, and energy spend. ESG may be the language, but CFOs are the audience.

Sustainability wins not because it sounds good, but because it makes the rest of the spreadsheet easier to defend.

6. The radiologist role expands, but not by stacking more work on the same shoulders.

Radiologists are still the image interpreters. But now they are also curators of data quality, owners of AI governance, partners in enterprise imaging strategy, and in some cases, the ones explaining results directly to patients.

That’s not a branding shift. It’s a relevance shift.

RSNA’s agenda reflects it: more leadership sessions, more business sessions, more “how this fits into system-wide care,” and less “here’s a niche thing only radiologists care about.” The field is starting to say the quiet part out loud: radiology doesn’t stay central to medicine by reading faster. It stays central by influencing more.

The radiologist of the future will not be defined by RVUs. They will be defined by impact.

The takeaway

If RSNA 2024 was about promise, RSNA 2025 is about proof.

Proof that AI belongs in the workflow.
Proof that imaging can scale without burning out the workforce.
Proof that capital investments can deliver both efficiency and quality.
Proof that individualized imaging isn’t a concept. It’s an operating model when the economics line up.

This is not the year radiology reinvents itself.
It is the year radiology decides what stays, what goes, and what the specialty will no longer make excuses for.