{"id":19756,"date":"2026-10-08T05:07:09","date_gmt":"2026-10-08T08:07:09","guid":{"rendered":"https:\/\/rtmedical.com.br\/tmp-en-1791446828526\/"},"modified":"2026-10-08T05:07:15","modified_gmt":"2026-10-08T08:07:15","slug":"us-imaging-deserts-teleradiology","status":"publish","type":"post","link":"https:\/\/rtmedical.com.br\/en\/us-imaging-deserts-teleradiology\/","title":{"rendered":"Imaging Deserts: Only 1.9% of Americans Lack Access"},"content":{"rendered":"<p><strong>Imaging deserts<\/strong> in the United States are less common than the radiologist-shortage debate implied: only 1.9% of the population, about 6.4 million people, lives in counties with neither installed imaging equipment nor a local radiologist. That is the headline of a national study in <em>Academic Radiology<\/em> that mapped both scanners and physicians across 3,144 counties. The more striking figure is a different one: more than half of all counties (53.8%) have no documented local radiologist at all, and teleradiology is what fills that gap.<\/p>\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" class=\"alignleft lazyload\" data-src=\"https:\/\/rtmedical.com.br\/wp-content\/uploads\/2026\/10\/us-imaging-deserts-county-chart.png\" alt=\"Chart: US counties classified by local presence of imaging equipment and radiologists, with 6% lower imaging use in true imaging deserts\" width=\"640\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1200px; --smush-placeholder-aspect-ratio: 1200\/630;\"><figcaption>County-level typology of local imaging access across 3,144 US counties, with differences in imaging use and Medicare payments between true deserts and fully served counties.<\/figcaption><\/figure>\n<h2>What the study did<\/h2>\n<p>The paper is by Adyasha Pradhan of the Touro College of Osteopathic Medicine (New York), Sharon D&#8217;Souza of American Radiology Associates (Dallas), and Andrew B. Rosenkrantz of the Department of Radiology at NYU Grossman School of Medicine. It was published online on October 3, 2026 (doi:10.1016\/j.acra.2026.09.030) and covered by The Imaging Wire.<\/p>\n<p>The aim was to merge two dimensions that are usually studied separately, where the machines are and where the radiologists are, into a single classification. For the workforce, the authors used the June 2026 release of the National Plan and Provider Enumeration System (NPPES). Radiologists were identified through six verified taxonomy codes and assigned to counties by practice ZIP code.<\/p>\n<p>For infrastructure, the definition combined three signals: presence of a hospital in the county, Medicare billing for computed tomography or magnetic resonance imaging, and certified mammography facilities. Each county then fell into one of four groups: true imaging desert (neither equipment nor radiologist), equipment-only, radiologist-only, and fully served (both). Sensitivity analyses repeated the exercise with diagnostic-only taxonomies, with radiologists billing Medicare, and with minimum billing-volume thresholds. A multivariable logistic regression modeled the factors linked to radiologist absence and to true-desert status.<\/p>\n<h2>The key numbers<\/h2>\n<p>Of the 3,144 counties, 1,692 (53.8%) had no documented local radiologist. The distribution looked like this:<\/p>\n<ul>\n<li><strong>True imaging deserts:<\/strong> 568 counties, home to 1.9% of residents (6.4 million people, per The Imaging Wire);<\/li>\n<li><strong>Equipment-only:<\/strong> 1,124 counties, with 7.6% of residents (25.9 million);<\/li>\n<li><strong>Radiologist-only:<\/strong> 19 counties, with 0.1% of residents;<\/li>\n<li><strong>Fully served:<\/strong> 1,433 counties, with 90.4% of residents (307.4 million).<\/li>\n<\/ul>\n<p>Access is not neutral for patients, though. Medicare imaging utilization was 3,989 per 1,000 beneficiaries in true deserts versus 4,242 per 1,000 in fully served counties (p&lt;0.001), a gap of roughly 6%. The difference held as the equipment definition changed. The Imaging Wire adds that Medicare payments per beneficiary were 8.9% lower in imaging deserts.<\/p>\n<p>Two sensitivity results help calibrate the picture. The share of counties without a radiologist ranged from 53.8% to 63.3% depending on the workforce definition. And when the unit of analysis moved from the county to the commuting zone, which groups counties by shared labor and service flows, the share without a radiologist fell to 16.8% and the share of true deserts to 1.7%. In the regression, smaller population and lower educational attainment predicted both radiologist absence and true-desert status.<\/p>\n<h2>Why radiology avoids the worst case<\/h2>\n<p>The gap between &#8220;53.8% of counties without a radiologist&#8221; and &#8220;1.9% of people in a desert&#8221; is largely the effect of separating image acquisition from interpretation. Unlike specialties that require a physician at the bedside, diagnostic radiology lets a CT be acquired at a rural hospital and read hundreds of miles away. The equipment-only group, with 25.9 million people, is precisely where that model operates: the scan happens locally and the report arrives over the network.<\/p>\n<p>That arrangement relies on pieces we have covered before: the struggle to staff positions outside major metros, discussed in <a href=\"https:\/\/rtmedical.com.br\/en\/zombie-jobs-radiologist-shortage-regional\/\">zombie jobs and the regional radiologist shortage<\/a>; the collapse of the VA&#8217;s national teleradiology program from 120 to 62 radiologists, in <a href=\"https:\/\/rtmedical.com.br\/en\/va-radiologist-exodus-systemic\/\">the VA radiologist exodus is systemic<\/a>; the arrival of AI-native reading groups, as with <a href=\"https:\/\/rtmedical.com.br\/en\/harrison-ai-frontier-teleradiology\/\">Harrison.ai and US teleradiology<\/a>; and the consolidation of independent practices into national networks such as <a href=\"https:\/\/rtmedical.com.br\/en\/affiliated-radiology-independent-network\/\">Affiliated Radiology<\/a>. Infrastructure matters too: as the Swiss study on <a href=\"https:\/\/rtmedical.com.br\/en\/radiology-ai-real-world-latency\/\">real-world radiology AI<\/a> showed, network latency and routing can delay results even when the algorithm itself is fast.<\/p>\n<p>The Imaging Wire points to the obvious exception: services that require a radiologist on site, such as interventional radiology, cannot be solved by teleradiology. The same broadly applies to image-guided biopsies and to exams that depend on on-site physician supervision. For those services, the empty 53.8% of counties is a real problem.<\/p>\n<h2>Practical implications, in the US and beyond<\/h2>\n<p>The authors&#8217; core message is about policy: equipment-only counties and true deserts call for different responses. In the first case the bottleneck is interpretation, and levers such as teleradiology incentives, broadband, PACS integration and interstate licensing and credentialing are likely to matter most. In the second, the physical point of entry is missing, and the answer involves installing or bringing equipment (mobile units, mammography vans, CT in small hospitals), which is far more expensive.<\/p>\n<p>The logic travels well. In Brazil, for example, teleradiology is regulated by the Federal Council of Medicine (CFM Resolution 2,107\/2014) and already supports many services in the interior of the country. The study contains no Brazilian data and no comparable figures exist here, but its method suggests a useful exercise for health managers anywhere: cross the registry of equipment and facilities with the location of radiologists to separate regions that lack reads from regions that lack the scan itself. For anyone planning PACS, data links and remote reading contracts, as in <a href=\"https:\/\/rtmedical.com.br\/en\/cloud-teleradiology-swivel-chair-reads\/\">cloud teleradiology with unified reading<\/a>, that distinction decides where investment pays off.<\/p>\n<h2>Limitations and outlook<\/h2>\n<p>Some caveats apply, several of them visible in the sensitivity data. The NPPES practice address does not always match where a radiologist actually works, and the 53.8% to 63.3% range shows how much the definition matters. Equipment presence was inferred from indirect signals (hospital, Medicare CT and MRI billing, certified mammography), which says little about capacity, wait times or travel distance. Utilization was measured in Medicare, a largely older population, and the cross-sectional design cannot attribute the 6% gap to lack of access: lower demand and travel to neighboring counties may explain part of it. The drop in true deserts to 1.7% at the commuting-zone level reinforces that administrative boundaries can overstate isolation.<\/p>\n<p>On conflicts of interest, Rosenkrantz reported grant funding from the American Roentgen Ray Society; the other authors declared none. Even with these caveats, the study offers a simple, reproducible typology that can track over time whether teleradiology is actually offsetting the concentration of radiologists in urban centers, and where it does not reach.<\/p>\n<p><strong>Source:<\/strong> <a href=\"https:\/\/theimagingwire.com\/2026\/10\/07\/how-common-are-imaging-deserts-in-radiology\/\" target=\"_blank\" rel=\"noopener\">The Imaging Wire<\/a> and <a href=\"https:\/\/doi.org\/10.1016\/j.acra.2026.09.030\" target=\"_blank\" rel=\"noopener\">Pradhan, D&#8217;Souza and Rosenkrantz, Academic Radiology 2026<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Academic Radiology study: 53.8% of US counties have no local radiologist, yet only 1.9% of residents live in a true imaging desert.<\/p>\n","protected":false},"author":5,"featured_media":19718,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"ngg_post_thumbnail":0,"_rt_cluster":"","fifu_image_url":"","fifu_image_alt":"","footnotes":""},"categories":[100],"tags":[],"class_list":["post-19756","post","type-post","status-publish","format-standard","has-post-thumbnail","category-radiology"],"aioseo_notices":[],"rt_seo":{"title":"","description":"Academic Radiology study: 53.8% of US counties have no local radiologist, yet only 1.9% of residents live in a true imaging desert.","canonical":"","og_image":"","robots":"index,follow","schema_type":"Article","include_in_llms":true,"llms_label":"US imaging deserts by county (Academic Radiology 2026)","llms_summary":"Pradhan, D'Souza, Rosenkrantz, Academic Radiology 2026 (doi:10.1016\/j.acra.2026.09.030): typology of 3,144 US counties (NPPES Jun 2026; hospital, Medicare CT\/MRI billing, certified mammography). 53.8% of counties lack a local radiologist. True deserts 568 counties\/1.9% of residents (6.4M); equipment-only 1,124\/7.6%; radiologist-only 19\/0.1%; fully served 1,433\/90.4%. Imaging use 3,989 vs 4,242 per 1,000 (-6%); Medicare payments -8.9%. Commuting zones: 16.8% no radiologist, 1.7% deserts.","faq_items":[],"video":[],"gtin":"","mpn":"","brand":"","aggregate_rating":[]},"_links":{"self":[{"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/posts\/19756\/"}],"collection":[{"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/posts\/"}],"about":[{"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/types\/post\/"}],"author":[{"embeddable":true,"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/users\/5\/"}],"replies":[{"embeddable":true,"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/comments\/?post=19756"}],"version-history":[{"count":1,"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/posts\/19756\/revisions\/"}],"predecessor-version":[{"id":19760,"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/posts\/19756\/revisions\/19760\/"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/media\/19718\/"}],"wp:attachment":[{"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/media\/?parent=19756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/categories\/?post=19756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rtmedical.com.br\/en\/wp-json\/wp\/v2\/tags\/?post=19756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}