Experts say radiology departments must adapt to 'obesity pandemic'
Radiology departments may need to rethink equipment, protocols and workflows as obesity continues to affect a growing share of the population, according to a new analysis.
The review details the technical, safety and operational challenges associated with imaging obese patients. It was prompted in part by parallels between the COVID-19 pandemic and what researchers describe as a chronic global obesity pandemic. The group notes that obesity can affect virtually every stage of radiologic care, from whether a patient can physically fit into an imaging system to excess radiation doses, image quality issues, patient transfers and interventional procedures. This warrants consideration for organizations planning equipment purchases and mapping out clinical workflows to optimize patient care, the team wrote in Academic Radiology.
“This situation, as occurs with COVID-19, is showing direct impact at the same time in society and healthcare, including radiology departments,” Teodoro Martín-Noguerol, MD, with the radiology department at HT Medica in Spain, and colleagues noted. “However, in our opinion, unfortunately, not every radiology department is ready to face the obesity pandemic, not only from a diagnostic scope, but especially regarding technical and logistical issues.”
The authors combed through all available literature on the topic to get a better idea of how obesity can impact radiologic care. They contend that the most pressing issue pertaining to obesity in radiology workflows is physical compatibility with imaging equipment. Gantry and bore dimensions can limit whether patients can undergo CT or MRI, while imaging tables have specified weight capacities. Positioning patients appropriately also can become more difficult as body habitus increases.
In CT and X-ray, increased tissue attenuation can require higher radiation exposure to obtain diagnostically useful images. At the same time, greater attenuation can degrade image quality through increased noise, photon starvation, truncation artifacts and reduced contrast resolution.
These technical constraints can make imaging more difficult even when equipment is technically capable of accommodating a patient. Radiology teams may need to modify protocols and positioning techniques to balance image quality with radiation dose and patient safety, the authors suggested.
Interventional radiology procedures in this demographic can create difficult circumstances as well. The review notes that obesity can complicate vascular access, prolong procedures and increase radiation exposure to operators. It is also associated with higher complication rates for some procedures.
Adapting to serve patients
These challenges make staff training and appropriate equipment increasingly important, the authors cautioned. Teams could require specialized knowledge of patient positioning, safe transfers and radiation protection, while departments must ensure they have access to bariatric-capable stretchers, tables and other equipment. The authors argue that adapting to patients with obesity requires more than simply purchasing larger equipment when existing systems become inadequate. Radiology departments should consider patient size and weight capacity when planning new equipment, designing imaging spaces and developing protocols.
The issue also has implications for equitable access to care. If a patient cannot be safely accommodated by available equipment, or if specialized resources are available only at certain facilities, obesity can become an additional barrier to timely diagnostic imaging. This could be consequential for millions of patients, as obesity is associated with numerous conditions that generate substantial demand for imaging and interventional procedures.
For radiology leaders, the issue represents both a clinical and operational planning challenge. As the prevalence of obesity grows, accommodating larger and more complex patients may become a routine consideration in equipment procurement, facility design, staffing and imaging protocol development.
“The obesity pandemic is not an emerging threat; it is already profoundly affecting everyday radiological practice. As radiology served as a vital frontline tool during the COVID-19 pandemic, it must now prepare for the long-term, pervasive demands of obesity,” the group concluded. “The question is no longer whether radiology departments can adapt, but how quickly they will choose to implement the necessary changes to ensure equitable, safe and high-quality imaging for all patients.”
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.