Rethink Imaging

In this episode of Rethink Imaging, host Chris St. John sits down with Dr. Kalpana Kanal and Dr. Thomas Griglock to discuss the newly updated Diagnostic Reference Levels (DRLs) and Achievable Doses (ADs) published ten years after the benchmark 2014 study. Analyzing a massive dataset of 5.2 million CT exams from 2025, they break down the 22% reduction in national DRLs, explain why low dose isn't always good dose, and emphasize why clinical optimization and diagnostic image quality must take precedence over endless dose reduction.

In this episode of Rethink Imaging, host Chris St. John sits down with Dr. Nina Kottler, Associate Chief Medical Officer of Clinical AI at Radiology Partners. Moving past basic lesion detection, Dr. Kottler addresses the massive 10x capacity-volume mismatch causing severe turnaround delays across healthcare systems. She breaks down the shift from fragmented, narrow AI tools to agentic foundation models and explains why funding clinical AI governance is key to sustainable medical innovation.

In this episode of Rethink Imaging, host Chris St. John sits down with Tobias Gilk, an internationally recognized MRI safety expert and founder of The Invisible Force podcast. Moving beyond standard compliance checklists, Tobias exposes the critical gaps in modern MRI safety training, regulatory oversight, and physical environment workflows. From analyzing the fatal 2025 Long Island projectile accident to revealing how safety inefficiencies secretly drain facility revenue, this conversation provides a definitive blueprint for protecting patients while maximizing operational throughput.

In this episode of Rethink Imaging, host Chris St. John sits down with Tobias Gilk, a world renowned healthcare architect and certified MRI safety expert. Moving beyond the standard industry assumption that MRI is entirely risk free due to its lack of ionizing radiation, Gilk pulls back the curtain on the critical, unique physical hazards lurking inside the magnet room. From analyzing tragic projectile accidents to tracing why modern imaging workflows are fundamentally broken, this conversation explores how true safety in radiology requires rethinking the architecture of patient screening from the ground up.

In this episode of Rethink Imaging, host Chris St. John sits down with Brandon Smith, the historic first-ever back-to-back sitting president of the American Society of Radiologic Technologists (ASRT). Moving past the typical industry discussions around staff shortages, Brandon challenges the medical imaging community to reject quiet martyrdom, step out from behind the "ancillary" shadow, and transition from mere volunteerism to aggressive professional advocacy.

In this episode of Frame by Frame: Rethink Imaging, host Chris St. John sits down with Dr. Tessa Cook, Vice Chair of Practice Transformation and Director of the Imaging Informatics Fellowship at Penn Medicine. Moving beyond the standard industry hype surrounding artificial intelligence, Dr. Cook pulls back the curtain on the critical infrastructure required to make advanced technology actually work on the clinical front lines. From pioneering open-source radiation dose tracking to designing enterprise-wide patient follow-up systems, this conversation explores how true innovation in radiology always starts with solving the workflow problem, not just writing better code.

In this episode of Rethink Imaging, host Chris St. John sits down with Dr. Aaron Sodickson, Division Chief of Emergency Radiology at Mass General Brigham and Associate Professor at Harvard Medical School, to pull back the curtain on how advanced CT technology is transforming patient care. Moving from standard grayscale imaging to full-body photon counting scanner operations, Dr. Sodickson reveals what it takes to bring cutting-edge clinical technology out of the development lab and onto the front lines of emergency medicine. From slicing patient radiation dose in half to wiping out diagnostic uncertainty, this conversation explores the massive leap forward in clinical radiology.

In this episode of Rethink Imaging, host Chris St. John sits down with Jill Shuman, a board-certified diagnostic medical physicist at the Marshfield Clinic, to pull back the curtain on the gritty reality of rural healthcare. Far removed from the massive budgets of big academic institutions, Jill oversees imaging safety and quality across a broad network of underserved facilities in Wisconsin and Michigan. From fighting "break-fix" budget constraints to navigating the quality risks of a 100% traveler technologist workforce, Jill reveals what it truly takes to protect patient lives in a system that wasn’t built for small towns.

In this episode of Rethink Imaging, host Chris St. John sits down with Dr. M. Mahesh, a world-renowned medical physicist from Johns Hopkins, to deconstruct the myths and misinformation surrounding medical radiation. Dr. Mahesh reveals how sensationalist headlines, like the "600% increase" in population radiation, often lack the scientific context necessary for patient safety. From the hidden dangers of lead shielding to how AI is changing the way we find health information, this conversation bridges the gap between academic "ivory towers" and the public’s need for clear, comforting, and accurate answers.

In part two of this deep dive, host Chris St. John and Dr. Mina Makary explore the "sci-fi" reality of modern interventional radiology. From ultrasound waves that destroy tumors without a single incision to embolization procedures that treat chronic pain and enlarged prostates, Dr. Makary reveals how the "fourth pillar" of cancer care is making major surgery a last resort rather than a first step.

In the first of a two-part series, host Chris St. John sits down with Dr. Mina Makary, a dual board-certified radiologist at The Ohio State University, to explore the rapidly evolving world of Interventional Radiology (IR). Dr. Makary clarifies the vital distinction between burnout and "moral injury" the psychological toll of being prevented from doing what is ethically right by systemic barriers, and advocates for a patient-centered approach that prioritizes transparency and minimally invasive options.

In this episode of Rethink Imaging, host Chris St. John sits down with Dr. Julie Bauml, a radiologist and clinical informatics expert, to dismantle the "replacement" narrative in medical AI. Dr. Bauml explains the concept of the "cognitive ceiling", the hard limit on human image processing, and argues that AI’s true value lies in automating the "non-doctoring" tasks to alleviate burnout rather than simply cranking up study volumes.

In this episode of Rethink Imaging, host Chris St. John speaks with Chalonda Jones-Thomas, founder of the Thomas Institute of Health Professions, about the urgent need to modernize medical imaging education. As technology outpaces traditional textbooks, Chalonda discusses her pioneering work in creating fully online, simulation-based training programs that serve working parents, rural communities, and active-duty military members.

What if nearly half of traditional autopsies could be avoided without sacrificing diagnostic certainty? In this episode of Rethink Imaging, host Chris St John speaks with Dr. Kalpana Kanal, Director of Diagnostic Physics at the University of Washington, and Dr. Jonathan Medverd, Chief of Radiology at Harborview Medical Center, about building one of the most advanced postmortem CT programs in the United States. Together, they share how a cross-campus collaboration between radiology and the medical examiner’s office has scanned 184 cases to date, avoided autopsy in approximately 45% of them, and demonstrated how virtual autopsy can improve efficiency, reduce costs, respect religious objections, and enhance forensic investigations. This conversation explores clinical validation, operational hurdles, PACS integration, billing challenges, and the long-term vision for forensic radiology fellowships in the U.S.

In this episode of Rethink Imaging, host Chris St. John sits down with Dr. Francesco Ria to explore a critical but often misunderstood concept in CT imaging: total risk. While radiation dose often dominates conversations around CT safety, Dr. Ria explains why clinical risk including missed diagnoses, delayed treatment, and underutilized imaging — frequently outweighs radiation risk when exams are not properly justified or optimized. The conversation reframes how imaging professionals, clinicians, and leaders should think about safety, appropriateness, and value in modern CT practice. Rather than focusing narrowly on dose reduction, Dr. Ria advocates for a more balanced approach that prioritizes diagnostic quality, patient outcomes, and evidence-based decision-making across the imaging pathway.

Dr. Claudia Kirsch joins Rethink Imaging to discuss how viruses like SARS-CoV-2 reshape the brain through inflammation, vascular injury, and immune pathways. From unexplained smell loss to the discovery of the nervus terminalis as a potential viral pathway, this episode highlights how advanced imaging is uncovering new insights into neuroinflammation and viral-driven disease including implications for cancer biology and long-term brain health.

Medical imaging faces a workforce crisis that cannot be solved with short-term staffing fixes. In this episode of Rethink Imaging, Chris St. John speaks with Geoffrey Roche, SVP of Healthcare at RizePoint, about why imaging remains a hidden profession, why more than 20,000 students sit on waiting lists every year, and how outdated accreditation models are limiting access to care. Geoffrey shares a systems-level view of workforce development, drawing from his experience across hospital systems, higher education, Siemens Healthineers, and global health education. The conversation explores apprenticeships, imaging assistants, retention challenges, and why imaging must evolve its training pathways if it wants a sustainable future.

James leads one of the region’s most advanced nuclear theranostics programs, using molecular imaging not only to diagnose cancer, but to guide and deliver treatment. This conversation stays grounded in practice: how patients are selected, how imaging drives decisions, and how programs actually get built. In this episode of Rethink Imaging, Chris St. John sits down with Dr. James Cassuto to unpack what theranostics looks like when it’s done right, inside a real health system, serving real patients.

In this episode of Rethink Imaging, Chris St. John sits down with Dr. Ali Tejani, a neuroradiology fellow at UCSF and a national leader in radiology education, imaging informatics, and AI literacy. Ali shares why radiology training programs must evolve now to prepare trainees for a future where AI is embedded in everyday clinical workflows. From launching an imaging informatics and business intelligence track during residency to co-directing national informatics education initiatives, Ali explains how radiologists learn best, why traditional didactics are no longer enough, and how podcasts, social media, and hands-on AI experiences are reshaping education. The conversation explores generational learning differences, the risk of deskilling, ethical AI use, and why being a critical, informed AI user matters more than knowing how to code.

In this episode of Frame by Frame: Rethink Imaging, host Chris St. John sits down with Jason Schneck, CEO of One Physics, to unpack how medical physics is evolving as care shifts beyond hospital walls. Jason shares a frontline view of how outpatient expansion, workforce shortages, regulatory complexity, and emerging technologies like molecular imaging and theranostics are reshaping the role of medical physicists. He explains why the profession remains underrecognized, how consolidation and outsourcing are not threats but structural responses to modern care delivery, and why flexibility, scale, and advocacy are becoming essential to patient safety and quality imaging.