ACR Launches New Benchmarking Tool

The ACR's Dose Index Registry (DIR) was first launched in 2011 for Computed Tomography (CT) to create a national database for comparing radiation dose indices. The registry, which now includes data from over 236 million exams from nearly 2,400 facilities, allows practices to benchmark their performance against regional and national averages. The goal is to identify outliers and optimize protocols, not just to lower doses but also to increase them when necessary to improve image quality and diagnostic confidence. Digital radiography represents the most common type of ionizing imaging exam, with over 275 million performed annually in the U.S. However, radiation exposure for the same exam can vary significantly—sometimes by as much as sevenfold—between different centers. The new DR module aims to establish benchmarks for common exams, similar to what has been achieved for the 10 most common adult CT scans. This benchmarking tool arrives as imaging services increasingly shift to outpatient settings, a trend driven by payer policies and the potential for significant cost savings. About 40% of all imaging volumes are now performed in outpatient centers, and advanced outpatient imaging is projected to grow 14% over the next decade. This shift is forcing health systems to develop strategies for freestanding imaging centers to remain competitive. The mobile imaging market is also expanding, with a projected value of $24.2 billion by 2032, fueled by an aging population and the demand for more accessible diagnostic services. Major players in this competitive space include RAYUS Radiology, DMS Health, TridentCare, Akumin Inc., RadNet Inc., and Probo Medical. These companies are expanding through partnerships and acquisitions to increase their regional presence. Consolidation is a major force across the imaging landscape, affecting both imaging centers and radiology practices. This trend is driven by reimbursement pressures, the need for sophisticated IT, and the move towards value-based care models. Notably, hospital-affiliated and private equity-backed radiology groups tend to charge significantly more for services than independent practices. In parallel, artificial intelligence is rapidly transforming radiology workflows. As of early 2026, the FDA has cleared over 1,000 AI-powered tools for clinical imaging, representing nearly 80% of all approved medical AI devices. These tools assist with tasks like flagging potential cancers, triaging urgent cases, and even drafting preliminary reports, demonstrating AI's growing role in improving diagnostic efficiency and accuracy.