Category: Lab Tests and Imaging

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Don’t Blame the Iodine For Reactions to Contrast Scans

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Patients may often be worried about reactions to the contrast agents used in their scans.

What is a contrast scan?

‘A contrast scan is a medical imaging test, such as a CT scan or MRI,’ says Dr Jean de Villiers, a radiologist and director of SCP Radiology, ‘that uses a special dye called a ‘contrast agent’ to make certain areas of the body easier to see. The contrast helps highlight blood vessels, organs or abnormal tissues, providing clearer and more detailed images. Dr de Villiers talks about the dye, what it is used for and debunks the myth that it is the iodine that causes allergic reactions in some people.

For MRI scans, a different type of contrast is used, which is gadolinium-based and, while allergic reactions are possible, they are extremely rare.

Why is it used?

The contrast agent shows the blood flow through arteries and veins, blockages, bleeding or abnormal growths and detailed organ structure (such as the brain, liver or kidneys).

In short, contrast helps to highlight differences between normal and abnormal tissue, improving diagnosis and treatment planning.

How is the dye administered?

The contrast agent is usually injected into a vein but, in some cases it can be swallowed or given as a rectal enema, depending on the area being examined. It temporarily changes the way radiation or magnetic fields interact with the body’s internal structures.

Is there an iodine allergy risk in a contrast scan?

This is a common concern, but it’s a bit misunderstood.

People often believe they are allergic to iodine because they may have reacted to contrast dye in the past or to shellfish, which contain iodine. However, iodine itself is not an allergen. According to radiologists and allergists, the body doesn’t mount an allergic immune response to iodine as it’s a basic element, essential to human health, particularly for thyroid function.

What causes allergic reactions in contrast scans?

The culprits are usually one of the other compounds, not iodine. Most contrast agents used in CT scans are iodinated contrast agents however, reactions tend to be linked to the chemical structure of the compound, not its iodine content.

Reactions may range from mild (nausea, itching, flushing) to more serious (difficulty breathing or anaphylactoid reactions), which mimic allergies but do not involve the immune system in the same way.

These reactions are typically caused by:

  • Concentration of the contrast agent
  • Molecular structure (ionic vs non-ionic)
  • Patient-specific factors such as history of allergies, asthma or previous reaction to contrast

Advancements in the type of contrast agent used have significantly reduced the rate of reactions in patients.

To confirm: It’s not the iodine, it’s the other compounds attached to the iodine in the dye and the body’s unique response to them. That is why patients are always asked about any previous contrast reactions, asthma or other allergies before being given the contrast injection.

‘Whether you are asked or not,’ says Dr de Villiers, it’s always best to inform the radiology team if you have had any previous allergic contrast reactions.’

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Blood Protein Levels Change Greatly from Childhood to Adulthood

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Blood protein levels change markedly already during childhood and adolescence, and differences between girls and boys become increasingly pronounced with age. This is shown by a new study in Nature Communications from Karolinska Institutet in collaboration with colleagues from SciLifeLab and KTH Royal Institute of Technology. The results suggest that blood protein levels change over the course of a lifetime, rendering adult reference values inadequate for children and adolescents.

In the study, the researchers analysed blood samples from 100 participants in the population-based BAMSE cohort at ages 4, 8, 16 and 24 years. Using advanced protein technology, over 5000 proteins were measured, of which just over 3500 could be tracked over time. More than half of these proteins changed with age even during childhood.

The greatest changes were observed between the ages of 8 and 16, a period that coincides with puberty. Many proteins increased sharply during this time, only to decrease again in early adulthood, whilst others showed more gradual increases or decreases from childhood to adulthood.

”Our study shows that reference values from adults cannot be used when interpreting protein levels in children and adolescents. Protein levels are strongly age-dependent even early in life, says one of the lead authors”, Sophia Björkander, assistant professor and docent at the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet.

The researchers also identified clear gender differences. In early childhood, the differences were few, but from adolescence onwards they increased markedly. By the age of 24, around 30 per cent of proteins differed between women and men, including those linked to growth, metabolism, the immune system and reproductive processes.

”Gender differences become very clear from adolescence and early adulthood. This shows that both age and gender are fundamental biological factors that must be taken into account when proteins are used as biomarkers”, says Sophia Björkander.

Blood proteins are used as biomarkers

Today, blood proteins are widely used as biomarkers to detect, for example, inflammation, hormonal imbalance, cardiovascular disease and metabolic disorders. An important finding from the study is that different levels of proteins in children may reflect normal development rather than disease.

”By mapping protein development, we are creating a reference that can be used to identify early deviations. This opens up possibilities for risk assessment of chronic diseases and more personalised medicine”, says senior/last author Erik Melén, project leader at BAMSE and professor at the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet.

The researchers point out that the number of participants is limited and that the results primarily apply to a relatively homogeneous population.

The study is part of the Human Disease Blood Atlas, which is a resource within the Human Protein Atlas and is based on the Swedish BAMSE cohort. The BAMSE project is jointly run by the Department of Clinical Science and Education, Södersjukhuset and the Institute of Environmental Medicine, both at Karolinska Institutet, as well as the Centre for Occupational and Environmental Medicine, Region Stockholm.

The research has been funded by, among others, the Swedish Research Council, Region Stockholm, the Swedish Heart-Lung Foundation and the Knut and Alice Wallenberg Foundation. The researchers state that there are no conflicts of interest.

Source: Karolinska Institutet

Categories : Lab Tests and ImagingTags :

Adcock Ingram Critical Care and Olympus Partner to Expand Medical Innovation in Southern Africa

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Ronald Boueri (Olympus Middle East and Africa) and Colin Sheen (Adcock Ingram Critical Care) signing the strategic partnership agreement.

JOHANNESBURG, (Apr. 23, 2026) – Adcock Ingram Critical Care (AICC), a leading manufacturer and supplier of hospital and critical care products in Southern Africa, and Olympus, a global MedTech company committed to advancing endoscopy-enabled care, are strengthening their focus on improving patient care through a strategic partnership.

The partnership will expand access to Olympus’ advanced endoscopy solutions and broader medical and surgical technologies across South Africa and the Southern African region. Through this collaboration, AICC will support healthcare professionals with innovative solutions and services for early detection, diagnosis and minimally invasive treatment, while also strengthening access to clinical support, training and education.

Olympus has appointed Adcock Ingram Critical Care as its authorised distributor in South Africa, reinforcing its commitment to delivering high-quality products, reliable service and strong local support to healthcare professionals and institutions. With a global focus on clinical excellence and a comprehensive medical and surgical portfolio, Olympus continues to partner with organisations that share its aim of improving patient safety and outcomes and elevating the standard of care in targeted disease states.

“We are confident that our collaboration with Adcock Ingram Critical Care in South Africa will enhance service levels, expand market reach, and ensure seamless access to Olympus products and expertise,” says Ronald Boueri, Vice President and Managing Director, Olympus Middle East and Africa. “Most importantly, this partnership will support healthcare professionals with the high standards of quality, service and support they rely on, while contributing to improved patient outcomes and advancing healthcare across the country.”

For decades, AICC has delivered essential medical solutions across a range of therapeutic areas, including hospital care, renal care, transfusion therapies, infusion systems, and advanced wound care. This partnership further strengthens AICC’s ability to connect global innovation with local healthcare needs, ensuring that all South Africans have access to critical, life-enhancing technologies, supported by strong clinical expertise and service.

“This partnership marks an important step forward in our ongoing commitment to improving access to quality healthcare across Southern Africa,” says Colin Sheen, Managing Director of Adcock Ingram Critical Care. “Through our collaboration with Olympus, we are equipping healthcare professionals with innovative solutions that support early detection, accurate diagnosis and minimally invasive treatment, helping to enhance clinical outcomes and strengthen healthcare delivery across the region.”

Categories : Cardiovascular Disease Lab Tests and ImagingTags :

Dual Imaging Identifies Cause of Heart Attack in Patients Without Blocked Arteries

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International study supports combining advanced imaging to guide diagnosis and care 

Photo by Joice Kelly on Unsplash

When Ashley Perlow felt a sharp pain shoot across her chest and into both wrists, she didn’t think it could be a heart attack. She was 36, a new mom, and otherwise healthy.

At the hospital, blood tests showed signs of a heart attack, but her arteries appeared normal.

Now, new research led by clinicians and researchers at NYU Grossman School of Medicine shows that in cases like hers, using two complementary heart imaging tests can identify the underlying cause of these heart attacks in most patients without coronary artery narrowing, helping guide diagnosis and medical treatment in a condition that often leaves patients without clear answers. The study is among the largest and most comprehensive to examine MINOCA, or myocardial infarction with non-obstructive coronary arteries, a condition that accounts for 6 to 15% of heart attacks and is about three times more common in women than men.

“When arteries are not badly blocked, it can be unclear what caused the event,” said Harmony R. Reynolds, MD, lead author and director of the Cardiovascular Clinical Research Center in the Leon H. Charney Division of Cardiology at NYU Langone Health. “What we show is that in most cases, we can find the underlying explanation, and most often it is a true heart attack. Our results support the need to do specialised imaging in all patients with MINOCA, because we could not reliably predict who will have specific imaging findings.”

The findings come from the Heart Attack Research Program (HARP), a large international, prospective study. The latest results were presented by Dr Reynolds as featured clinical research at the American College of Cardiology’s 2026 Annual Scientific Session and simultaneously published March 28 in Circulation.

Dr Reynolds and the team found that combining coronary optical coherence tomography (OCT) and a cardiac magnetic resonance imaging (MRI) identified the underlying cause of the heart event in 79 percent of study participants.

How Advanced Diagnostic Imaging Reveals the Cause

To better understand these cases in both women and men, researchers enrolled 336 patients across 28 international sites in the Unites States, Canada, and the United Kingdom. The median age of participants was 58 years, including 270 women and 66 men.

Using coronary OCT and cardiac MRI, researchers identified underlying causes, assessed how often each test provided a diagnosis, and examined differences between sexes.

During coronary OCT, a thin catheter is placed inside the coronary arteries to capture high-resolution images of the artery wall, helping detect plaque buildup or blood clots that may not appear on a standard angiogram. Cardiac MRI provides detailed images of the heart muscle, showing where damage has occurred and whether it is related to reduced blood flow, inflammation, or another cause.

Using both imaging techniques together, researchers identified a likely cause in 79% of patients.

Most (59%) had a typical heart attack mechanism related to reduced blood flow from plaque buildup, artery spasm or blood clotting, while 20% (67 patients) had conditions that mimic a heart attack, such as myocarditis, takotsubo syndrome, or other cardiomyopathies. These nonischaemic conditions require different treatment approaches than traditional heart attacks.

The new research builds on earlier work by Dr Reynolds and colleagues, published in 2020 in Circulation, that demonstrated the value of using the same imaging methods in a smaller group of women. The current study expands those findings to a larger, more diverse international population.

Implications for Patient Care

The findings provide important support for current clinical guidelines, which recommend additional imaging in these patients but have largely been based on expert consensus rather than large-scale data. The results also highlight the limitations of standard angiography, which shows blood flow but cannot detect problems within the artery wall or subtle heart muscle injuries.

The combination of OCT and cardiac MRI provided a significantly higher diagnostic yield than either test alone. The study also found that doctors cannot reliably predict which patients will benefit from one imaging test versus another based on symptoms, blood tests, or initial findings. Even patients with relatively low levels of cardiac biomarkers frequently had detectable heart damage on imaging.

“We had hoped to be able to tailor testing to individual patients,” said Dr Reynolds. “Instead, we found that comprehensive imaging is often necessary to get the full answer.”

Although MINOCA occurs more frequently in women, researchers found no significant differences in the underlying causes between women and men once the condition developed. This suggests that the disease process itself is similar once it occurs.

For Perlow, that clarity was critical. After months of unanswered questions, she was referred to Dr Reynolds at NYU Langone, where further evaluation and testing helped officially diagnose her condition as MINOCA and guide her care.

Source: NYU Langone Heath

Categories : Diet and Nutrition Lab Tests and ImagingTags :

People Who Consume Ultra-Processed Foods Have Worse Muscle Health

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Thigh muscle fat identified as a potential modifiable risk factor for knee osteoarthritis

Representative axial T1-weighted spin-echo thigh MRI scans in (A) a 61-year-old female participant and (B) a 62-year-old female participant. Both participants were of similar age and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared). Both had Physical Activity Scale for the Elderly scores above the mean score in the study. According to the World Health Organization definition, the participant in B qualified as having abdominal obesity (abdominal circumference ≥ 88 cm). Abdominal circumference is a measure of central obesity that captures fat distribution and serves as an indicator of cardiometabolic health. Compared with the participant in A, the participant in B had a higher proportion of ultra-processed food (UPF) in their diet (87.1% vs 29.5%) and exhibited fattier thigh muscles bilaterally, with Goutallier grade (GG) for all thigh muscles summing to 25 for the participant in A and 38 for the participant in B.

https://doi.org/10.1148/radiol.251129 ©RSNA 2026

Researchers found that a diet high in ultra-processed foods is associated with higher amounts of fat stored inside thigh muscles, regardless of calorie or fat intake, physical activity or sociodemographic factors in a population at risk for knee osteoarthritis. Results of the study were published in Radiology.

Ultra-processed foods usually have longer shelf lives and can be highly appealing and convenient. They contain a combination of sugar, fat, salt and carbohydrates which affect the brain’s reward system, making it hard to stop eating.

“Over the past decades, in parallel to the rising prevalences of obesity and knee osteoarthritis, the use of natural ingredients in our diets has steadily diminished and been replaced by industrially-processed, artificially flavored, colored and chemically altered food and beverages, which are classified as ultra-processed foods,” said the study’s lead author, Zehra Akkaya, MD, researcher and consultant for the Clinical & Translational Musculoskeletal Imaging group at University of California, San Francisco, Department of Radiology and Biomedical Imaging.

Dr. Akkaya and the research team set out to assess the relationship of ultra-processed food intake and intramuscular fat in the thigh.

For the study, researchers analyzed data from 615 individuals who participated in the Osteoarthritis Initiative who were not yet affected by osteoarthritis, based on imaging. The Osteoarthritis Initiative is a nationwide research study, sponsored by the National Institutes of Health, that helps researchers better understand how to prevent and treat knee osteoarthritis.

“Osteoarthritis is an increasingly prevalent and costly global health issue,” Dr. Akkaya said. “It constitutes one of the largest non-cancer-related health care costs in the United States and around the world. It is highly linked to obesity and unhealthy lifestyle choice.”

Of the 615 individuals, (275 men, 340 women) the average age was 60 years. On average, participants were overweight with a body mass index (BMI) of 27. Approximately 41% of the foods they consumed over the prior year were ultra-processed.

The researchers found that the more ultra-processed foods people consumed, the more intramuscular fat they had in their thigh muscles, regardless of caloric intake.

“In addition to investigating the quality of our modern diet in relationship to thigh muscle composition, in this study, we used widely available, non-enhanced MRI, making our approach accessible and practical for routine clinical use and future studies,” Dr. Akkaya said. “These MRIs do not require advanced or costly technology, which means they can be easily incorporated into standard diagnostic practices.”

Source: Radiological Society of North America

Categories : Implants and Prostheses Lab Tests and ImagingTags :

Is it Safe to Have an MRI After Hip or Knee Replacement Surgery?

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A patient with a knee replacement undergoing an MRI where modern technology reduces the distortions in the images.

It is a common concern for patients that metal implants, such as hip or knee replacements, may prevent them from having an MRI scan. In most cases, this is not true. Patients with modern joint replacements can safely undergo MRI, depending on the materials used in the implant. It is important to inform the radiology team about the implant before your scan.

Dr Jean de Villiers, a radiologist and director of SCP Radiology, answers some of the questions most frequently asked by patients, specifically around the process from referral to reporting in radiology imaging.

What is Magnetic Resonance Imaging (MRI)?

MRI is a non‑invasive imaging technique that uses powerful magnets and radio waves to create detailed images of the body’s internal structures. Unlike X‑rays or CT scans, MRI does not involve ionising radiation and is used extensively to diagnose a wide range of conditions.

Because MRI uses strong magnetic fields, many patients ask whether it is safe to have an MRI after a hip or knee replacement.

Can you have an MRI after a hip or knee replacement?

Yes, you can have an MRI scan on other parts of the body, as well as on the knee or hip where the implant is. Although some older MRI scanners may not be compatible with certain prostheses, the vast majority of MRI equipment in use today is safe and compatible with modern hip and knee implants.

How safe is MRI if the implant is made of metal?

Most implants are made from titanium or cobalt‑chromium alloys. Although these materials are metallic, they are not significantly affected by the magnetic field of an MRI scanner, nor do they heat up during the scan. Many implants also contain hard plastic components, all of which are designed to be compatible with MRI scanners. They are not attracted to the powerful magnet in the same way as older or highly magnetic materials.

Dr de Villiers explains, “The vast majority of joint replacements used today are MRI‑safe. The key is that we know about them in advance, so we can adjust the scan if needed.”

What is the main challenge with MRI and an implant?

The main challenge is image quality. Metal can sometimes cause image distortion, known as artefact, on MRI images. This may make it more difficult to assess structures close to the implant. However, modern MRI techniques have improved significantly and can often minimise these effects, allowing radiologists to assess surrounding tissues such as muscles and ligaments, and to detect complications such as infection or loosening. MRI is often the best imaging method for evaluating pain or complications after joint replacement surgery.

What happens if MRI does not produce clear diagnostic images?

In some cases, alternative imaging techniques such as CT or ultrasound may be recommended, depending on the clinical question. However, MRI remains safe and highly valuable for many patients with joint prostheses.

Are there implants that prevent you from having an MRI?

Certain implants and devices may be unsafe or require special precautions during MRI, including:

  • Implanted pacemakers
  • Intracranial aneurysm clips
  • Cochlear implants
  • Certain prosthetic devices
  • Implanted drug‑infusion pumps
  • Neurostimulators
  • Bone‑growth stimulators
  • Any other iron‑based metal implants

MRI is also contraindicated in the presence of some internal metallic objects such as bullets or shrapnel, as well as certain surgical clips, pins, plates, screws, metal sutures or wire mesh.

Having a hip or knee replacement does not automatically exclude you from having an MRI scan. With modern implants and appropriate planning, MRI is both a safe and important diagnostic tool. As technology continues to evolve, future developments are expected to further enhance MRI compatibility with hip and knee implants, making it an even more reliable tool for ongoing patient care.

It is crucial for patients to inform their healthcare providers about their joint replacement before undergoing an MRI. This allows the medical team to adjust the MRI settings and take appropriate precautions to ensure both safety and diagnostic accuracy.

Categories : Lab Tests and ImagingTags :

World Voice Day: UP Researchers Develop Low-cost Voice Screening Device for SA

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Dr Maria du Toit takes a close-up look at vocal cords, capturing high-resolution images and video using widely available mobile technology. Traditionally, this type of examination requires expensive equipment and specialist doctors, making it difficult to access in many parts of South Africa

Ahead of World Voice Day on 16 April, researchers at the University of Pretoria (UP) are inviting the public to take part in free voice checks using a new, locally developed device that could significantly expand access to vocal health services across South Africa.

The groundbreaking, low-cost, smartphone-compatible device, which is currently being tested as part of ongoing research, enables clinicians and trained users to take a close-up look at the voice user’s vocal cords by capturing high-resolution images and video using widely available mobile technology. Traditionally, this type of examination – known as laryngoscopy – requires expensive equipment and specialist doctors, making it difficult to access in many parts of South Africa.

“Your voice is something you use every day – whether for work, social interactions, or simply being heard. Yet many people ignore early warning signs of vocal problems,” says Professor Jeannie van der Linde, who is leading the research team and is Head of UP’s Department of Speech-Language Pathology and Audiology in the Faculty of Humanities.

Voice disorders are more common than many people realise. Prof Van der Linde adds: “International estimates suggest that up to one in five people will experience a voice problem at some point in their lives, with higher risk for those who rely heavily on their voices for work, such as teachers, healthcare workers and call centre agents. Despite this, access to specialised diagnostic services remains limited, particularly outside major urban centres.”

The research and device are part of a broader effort to rethink how vocal health services are delivered in South Africa. “Our aim was to develop a solution that is more portable, more affordable and easier to integrate into different healthcare contexts,” says Dr Maria du Toit, a Lecturer in Speech-Language Pathology and member of the research team.

“Many people ignore early signs like hoarseness or vocal fatigue, often because they don’t have easy access to assessment services,” Dr Du Toit says. “If we can identify these issues earlier, we can intervene sooner and potentially prevent more significant problems from developing.

The development of the device forms part of ongoing efforts within the department to explore how mobile anddigital technologies can be used to increase the availability of vocal health assessment and care.

Dr Roxanne Malan, a postdoctoral fellow, speech therapist and research team member, highlights the importance of designing technology that balances functionality with affordability and ease of use. “We wanted to ensure that the device is not only clinically useful but also practical in a range of settings, including those withlimited resources,” she says. “The goal is to make vocal health screening more widely available without compromising on quality.”

The technology, which has not been named yet, is being developed at UP and is currently undergoing testing to compare its performance with gold-standard laryngoscopy. “We started feasibility testing in June 2025 and preliminary tests have been very positive, demonstrating that the device is usable and produces high-quality images of the relevant structures,” Dr Malan says. “It consists of a low-cost, off-the-shelf borescope – typically used industrially – adapted with a 3D-printed handle to ensure optimal placement of the scope in the patient’s mouth, as well as the correct angle for visualisation. We have also assessed its safety for human use and its ability to be properly disinfected.”

In addition to testing the device, the World Voice Day initiative seeks to increase general awareness about theimportance of vocal health. “Your voice is central to how you communicate, work and engage with others,” Dr DuToit says. “Taking care of it should be seen as an essential part of overall health, not something to think aboutonly when there is a problem.”

Dr Malan says the team’s vision is for the scope to be readily available as a screening device in public hospitalsand clinics all over South Africa and other low- and middle-income countries. “But we still foresee numerousphases of testing to ensure that it can be used by a range of healthcare professionals, and that it makes asignificant difference in the target healthcare sectors. We will name and launch it at a stage when this has beendone.”

Dr Du Toit says members of the public can support the research by booking their free voice health check. “Byattending, you’re not only taking care of your own vocal health – you’re helping researchers develop solutionsthat could make voice care more easily available to thousands of people who currently don’t have access tothese services.”

Event details: Members of the public are invited to take part in free voice checks on World Voice Day, 16 April 2026, at the Department of Speech-Language Pathology and Audiology at the University of Pretoria’s Hatfield Campus.

Participants will have the opportunity to learn more about their vocal health and contribute to research that aims to make voice care more accessible across South Africa.

Who should consider a voice check?

This free check is especially recommended for:

● Teachers and lecturers

● Singers and performers

● Healthcare workers

● Clergy and public speakers

● Call centre workers

● Anyone who uses their voice extensively

You should also consider attending if you:

● frequently experience hoarseness or voice changes;

● feel your voice tires easily;

● have ongoing throat discomfort when speaking; and/or

● simply want reassurance that your voice is healthy.

To register, visit: https://forms.gle/imqeHnpGveQaEuDD6


Categories : Lab Tests and ImagingTags :

Diagnostic Tests are Being Neglected as Pharmaceuticals Advance

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Source: Unsplash CC0

A new analysis from UC San Francisco argues that diagnostics are being overlooked both in the United States and around the world. This is slowing progress against major diseases, despite rapid advances in targeted therapies and precision health.

The authors note that nearly half of the world’s population lacks adequate access to diagnostics. These tests receive less investment for research and development, as well as lower insurance reimbursement than drugs, and this is creating barriers to innovation.

“Most people can easily understand how a new drug or surgery might help a patient,” said Kathryn Phillips, Ph.D., a professor of Health Economics in the School of Pharmacy at UC San Francisco and the lead author of the study, which appears in Science. “But the tests that guide medical decisions are just as critical.”

When treatments advance faster than tests

Advances in therapies are outpacing the development of the tests that are needed to guide their use. For example, many people do not respond to GLP-1 drugs for obesity and diabetes, but few tests exist yet to predict which patients will benefit.

Alzheimer’s is another example. New drugs exist to slow disease progression, but the blood tests that could match patients to the most beneficial drugs cost around $1000 and, unlike the drugs, which cost $30 000 a year, they rarely qualify for insurance coverage. This can leave doctors to make medical decisions without the necessary information. Some patients may not get the right treatments, and others may not get any treatments.

Regulatory misalignment and policy fixes

Even though they are essential to care, these diagnostic tests are often handled apart from the treatments they support. The FDA reviews tests differently than drugs, and insurers pay for them differently. Drugs are also much more likely to receive expedited FDA review than tests.

“Regulatory and payment policy should evolve in tandem with scientific and technological advances,” said Robert M. Califf, MD, former commissioner of the FDA and co-author of the paper.

“The current misalignment between how we evaluate diagnostics for consideration of allowing marketing and the system for reimbursement decisions about diagnostics versus drugs leaves powerful tools on the shelf and provides inadequate data to make good decisions about which diagnostic tools should be eschewed for lack of benefit in the real world.”

The authors say there are clear steps policymakers can take to fix these gaps, including reviewing tests and treatments together, streamlining approvals for tests, and improving how diagnostics are evaluated and paid for.

“Our hope is that this work helps people – patients, policymakers, insurers, and researchers – recognise diagnostics as essential to good health care – and not just an afterthought,” said Phillips, who directs the UCSF Center for Translational and Policy Research on Precision Medicine (TRANSPERS) and is a member of the Philip R. Lee Institute for Health Policy at UCSF.

Source: EurekAlert!

Categories : IT in Healthcare Lab Tests and ImagingTags :

Deepfake X-Rays Fool Radiologists and AI

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Findings raise concerns about cybersecurity and diagnostic trust

Anatomy-matched real and GPT-4o-generated radiographs: (A) real and (B) GPT-4o-generated posteroanterior chest radiographs, (C) real and (D) GPT-4ogenerated lateral cervical spine radiographs, (E) real and (F) GPT-4o-generated posteroanterior hand radiographs, and (G) real and (H) GPT-4o-generated lateral lumbar spine radiographs. The pairs demonstrate that GPT-4o can produce radiographically plausible images across different anatomic regions.
https://doi.org/10.1148/radiol.252094 ©RSNA 2026

Neither radiologists nor multimodal large language models (LLMs) are able to easily distinguish AI-generated “deepfake” X-ray images from authentic ones, according to a study published in Radiology. The findings highlight the potential risks associated with AI-generated X-ray images, along with the need for tools and training to protect the integrity of medical images and prepare health care professionals to detect deepfakes.

The term “deepfake” refers to a video, photo, image or audio recording that appears real but has been created or manipulated using AI.

“Our study demonstrates that these deepfake X-rays are realistic enough to deceive radiologists, the most highly trained medical image specialists, even when they were aware that AI-generated images were present,” said lead study author Mickael Tordjman, MD, post-doctoral fellow, Icahn School of Medicine at Mount Sinai, New York. “This creates a high-stakes vulnerability for fraudulent litigation if, for example, a fabricated fracture could be indistinguishable from a real one. There is also a significant cybersecurity risk if hackers were to gain access to a hospital’s network and inject synthetic images to manipulate patient diagnoses or cause widespread clinical chaos by undermining the fundamental reliability of the digital medical record.”

Seventeen radiologists from 12 different centers in six countries (United States, France, Germany, Turkey, United Kingdom and United Arab Emirates) participated in the retrospective study. Their professional experience ranged from 0 to 40 years. Half of the 264 X-ray images in the study were authentic, and the other half were generated by AI. Radiologists were evaluated on two distinct image sets, with no overlapping between the datasets. The first dataset included real and ChatGPT-generated images of multiple anatomical regions. The second dataset included chest X-ray images—half authentic and the other half created by RoentGen, an open-source generative AI diffusion model developed by Stanford Medicine researchers.

When radiologist readers were unaware of the study’s true purpose, yet asked after ranking the technical quality of each ChatGPT image if they noticed anything unusual, only 41% spontaneously identified AI-generated images. After being informed that the dataset contained synthetic images, the radiologists’ mean accuracy in differentiating the real and synthetic X-rays was 75%.

Individual radiologist performance in accurately detecting the ChatGPT-generated images ranged from 58% to 92%. Similarly, the accuracy of four multimodal LLMs—GPT-4o (OpenAI), GPT-5 (OpenAI), Gemini 2.5 Pro (Google), and Llama 4 Maverick (Meta)—ranged from 57% to 85%. Even ChatGPT-4o, the model used to create the deepfakes, was unable to accurately detect all of them, though it identified the most by a considerable margin compared to Google and Meta LLMs.

Radiologist accuracy in detecting the RoentGen synthetic chest X-Rays ranged from 62% to 78% and the LLM models’ performance ranged from 52% to 89%.

There was no correlation between a radiologist’s years of experience and their accuracy in detecting synthetic X-ray images. However, musculoskeletal radiologists demonstrated significantly higher accuracy than other radiology subspecialists.

Spotting the Risks in Synthetic Imaging

“Deepfake medical images often look too perfect,” Dr. Tordjman said. “Bones are overly smooth, spines unnaturally straight, lungs overly symmetrical, blood vessel patterns excessively uniform, and fractures appear unusually clean and consistent, often limited to one side of the bone.”

Recommended solutions to clearly distinguish real and fake images and help prevent tampering include implementing advanced digital safeguards, such as invisible watermarks that embed ownership or identity data directly into the images and automatically attaching technologist-linked cryptographic signatures when the images are captured.

“We are potentially only seeing the tip of the iceberg,” Dr. Tordjman said. “The logical next step in this evolution is AI-generation of synthetic 3D images, such as CT and MRI. Establishing educational datasets and detection tools now is critical.”

The study’s authors have published a curated deepfake dataset with interactive quizzes for educational purposes.

For More Information

Access the Radiology study, “The Rise of Deepfake Medical Imaging: Radiologists’ Diagnostic Accuracy in Detecting ChatGPT-generated Radiographs,” and the related editorial, “The Democratization of Deceit: Seeing Is No Longer Believing.”

Source: Radiological Society of North America

Categories : Lab Tests and Imaging Respiratory DiseasesTags :

UP Researchers Innovate Handheld Detection Device that Could Transform TB Screening

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The new MARTI TB screening device

With their innovation of a small but powerful handheld device, researchers at the University of Pretoria (UP) are on course to redefine the tuberculosis (TB) screening process, which could ultimately help to combat the TB pandemic more effectively. TB is one of the deadliest infectious diseases worldwide, claiming more than 1.25 million lives each year, of which about 50 000 deaths occur in South Africa. It is the leading cause of death among people with HIV.

MARTI (mycolate antibody real-time immunoassay) is the name of the handheld device that can provide very high certainty that a person at risk does not have TB. Using just one drop of blood – and no laboratory – it is set to change the way TB is detected. It may even be adapted for use in both human and veterinary healthcare. The diagnostic is fast, accurate, affordable and – the intellectual part of it – proudly South African.

An internal validation trial was recently completed to confirm the accuracy of the test. These trial results show remarkable promise in terms of the specificity, sensitivity and accuracy of the diagnostic test, coming close to the range of targets set by the World Health Organization for the “perfect” test, making MARTI an ideal screening and diagnostic tool. An earlier trial demonstrated great potential in using this test to monitor TB treatment; these results were published in the journal Biomarkers in Medicine.

“Many people aren’t aware that TB doesn’t always sit in the lungs – it can be present in bones, joints and the brain,” says Professor Jan Verschoor, former research leader of UP’s Tuberculosis Research Group in the Department of Biochemistry, Genetics and Microbiology and now an emeritus professor of biochemistry who has been leading this discovery. “The ‘gold standard’ TB test that involves growing cultures from lung sputum can take about six weeks, by which time, many more people could have been infected by the patient or the patient’s health could have deteriorated beyond the prospect of cure. From a simple finger-prick blood sample, the MARTI test gives us a result in 30 minutes. This has profound cost and public health implications in a country like South Africa, where we conduct three to five million TB tests a year.

Tuberculosis bacteria. Credit: CDC

Caused by Mycobacterium tuberculosis, this resilient bacterium has long evaded simple detection methods, particularly in regions where healthcare infrastructure is limited. But now, an unexpected hero has emerged in the war on TB: a molecule in the bacterium’s waxy coat – specifically its mycolic acid (MA) – holds the key. These wax-like substances form a nearly impenetrable barrier, making the bacterium both drug-resistant and difficult to detect.

But while other scientists focused on breaking through this barrier, Prof Verschoor took a different approach: what if the wax itself could be used to detect the disease? He was the first to demonstrate that antibodies to the waxes are reliable indicators of active TB, irrespective of whether someone had been vaccinated or was coinfected with HIV.

A key aspect of the innovation came from Carl Baumeister, a PhD candidate under Prof Verschoor. He made the leap from slow laboratory-based biosensing to a handheld device that detects anti-MA antibodies accurately and affordably in less than 30 minutes. The result is a test that’s as clever as it is simple and cost-effective.

Detecting these anti-MA antibodies requires sophisticated sensing technology: the surface of a screen-printed carbon electrode is pre-coated with a thin layer of MA. MARTI works by flowing a drop of blood over this electrode. If a patient has TB, the sensor detects these antibodies in the blood sample; if a patient does not have TB, no signal would be generated since there are no anti-MA antibodies in the blood sample.

“The device fits in the palm of your hand and requires only a single drop of blood – no sputum, no needles, no laboratory,” says Carl Baumeister, Head of Operations of the UP spin-off company MARTI TB Diagnostics. “This may become a game-changer to diagnose TB in paediatric and HIV-positive patients, where obtaining sputum samples is often neither feasible nor safe. The same could apply to the 20% of all extra-pulmonary cases.”

“If MARTI says you don’t have TB, you can trust it,” Baumeister says. “That’s a critical trait when trying to rule out cases during an outbreak or in mass screening campaigns, much like what was needed during the COVID-19 pandemic.

Unlike other TB diagnostics, MARTI offers something rare and powerful: near-perfect negative predictive value in typical screening applications.

The internal validation trial across six healthcare facilities in Tshwane was led by Prof Veronica Ueckermann, Head of Infectious Diseases at Steve Biko Academic Hospital and UP’s Faculty of Health Sciences.

“Collecting, transporting, processing and analysing the samples from the various sites within the temperature and time constraints of the validation trial protocol posed a significant logistical challenge – but we succeeded,” says Mosa Molatseli, a senior research scientist who heads up the MARTI laboratory.

Recognising its potential, UP established the start-up company MARTI TB Diagnostics (Pty) Ltd to develop and eventually commercialise MARTI.

“This is designed to ensure that the technology remains in South African hands while attracting investment and serving global needs,” says Gerrie Mostert, interim CEO of the company. “The next steps are to get investors, funding and partner organisations on board, obtain regulatory approval and start manufacturing the kit. Ultimately, MARTI should be rolled out to clinics worldwide.”