Radiologists in recent years have discussed the possibility of “opportunistic screening,” using artificial intelligence to systematically scan routine images for other incidental findings and also furthering population health purposes. A panel of experts recently dove into this idea to assess some of the barriers, sharing their insights May 23 in Radiology.

Radiography, ultrasound or MRI could all potentially serve this purpose. But most discussions to date have focused on body CT, a high-volume modality able to provide “valuable risk stratification and help detect unsuspected, presymptomatic disease.” AI serves as a key element to making these screening programs work, but more due diligence is needed.

“Regulatory and reimbursement hurdles are not insurmountable but pose substantial challenges to commercialization and clinical use,” lead author Perry J. Pickhardt, MD, with the University of Wisconsin School of Medicine & Public Health, and co-authors noted. “Through demonstration of improved population health outcomes and cost-effectiveness, these opportunistic CT-based measures should be attractive to both payers and healthcare systems as value-based reimbursement models mature. If highly successful, opportunistic screening could eventually justify a practice of standalone ‘intended’ CT screening.”

Pickhardt et al. waded into some of the particulars of how Current Procedural Terminology (CPT) coding might address these exams. But prior to any conversation with the CPT Editorial Panel, there would need to be research on the evidence of screening’s impact on patient care, costs and outcomes. The possibility of further population health goals is enticing, but radiologists and others will need to lay the groundwork first, the panel argued.

“Opportunistic screening can help uncover patient-level risk factors that could lead to serious disease in the future,” Pickhardt and colleagues wrote. “Early intervention in managing such risk factors would hopefully lead to better patient outcomes and affordable overall cost of care. Opportunistic applications that provide such improvements in patient outcomes at a lower or neutral cost would likely be adopted without any direct payment vehicle, such as achievement of CPT code categories 1–3.”

“Systematic opportunistic screening offers great potential to add value to the imaging services that radiologists already provide to their patients,” the team concluded later.

Read much more on the topic—including radiologist/referrer workload concerns and technical challenges—in RSNA’s flagship journal at the link below: