Why Advances in Cancer Imaging Underline Growing Need for Subspecialty Radiology Reporting as Standard
- Dr Amy Davis
- 5 days ago
- 6 min read
The rapid advances in cancer imaging over the past ten years are a clear sign that radiology as a whole is shifting towards more specialist reporting. Newer techniques like whole-body MRI (WB-MRI) offer unprecedented detail and coverage, enabling advanced diagnostic reporting without the risks of radiation and giving patients access to earlier cancer diagnosis.
In 2024, the Institute of Cancer Research found that WB-MRI benefits patients with a genetic mutation linked to a very high risk of cancer. Professor Gareth Evans, Professor of Medical Genetics and Cancer Epidemiology at the University of Manchester, commented: “[WB-MRI] is a major breakthrough for patients with TP53 gene faults as for the first time they can have a surveillance test that is likely to detect most of the malignancy risk early.”
The challenge of working with new advancements like WB-MRI is that it will throw up a high number of incidental non-harmful findings which can be difficult to rule out without specialist knowledge. This is where sub-specialty reporting has become so important, as using an expert with a deep understanding of the specific clinical context speeds up interpretation and improves reporting accuracy.
A New Era of Advanced Cancer Imaging
WB-MRI has emerged as a game-changer in oncology imaging. Unlike traditional scans that target a single region, WB-MRI can survey the entire body in one session – from brain to bones to liver – providing a comprehensive oncology imaging review. This technique is radiation-free and highly sensitive, making it especially valuable for cancer patients who require frequent imaging. Initially developed to detect bone metastases, modern WB-MRI now extends to all organ systems, offering both detailed anatomical images and functional insights (for example, diffusion-weighted imaging reveals tumour activity in bone marrow or soft tissues).
Technological progress has significantly improved WB-MRI’s feasibility. Advanced MRI protocols (such as Dixon sequences and 3D whole-body scans) and AI-powered image optimisation have cut scan times dramatically. A few years ago, a whole-body MRI might take 60+ minutes; today, streamlined protocols allow complete cancer screening MRI exams in under 30 minutes.
Faster scans take up less time for patients and also increase the number of scans that can be performed each day – which allows patients to be diagnosed and begin treatment more quickly.
From Generalist to Subspecialist: The Future of Radiology
In the past, a general radiologist might be expected to interpret all imaging studies, from head MRI to foot X-ray. Today, with the explosion of medical knowledge and imaging modalities, it is nearly impossible for one person to master every niche of radiology.
Subspecialists tend to stay up to date on the latest techniques and nuances in their domain. For advanced cancer imaging like WB-MRI, having a subspecialist’s eyes on the scans can mean the difference between a critical finding being recognised or overlooked.
Research has shown that subspecialty interpretations improve diagnostic accuracy and clarity. In one study, second opinion reads by subspecialty radiologists were found to be more accurate than the original general reports in over 80% of cases when checked against biopsy results. Another study reported that oncologists strongly prefer imaging reports from subspecialised radiologists – rating them clearer, more detailed, and more useful for patient management than general radiologist reports. Simply put, subspecialist reporting can reduce diagnostic errors and avoid the costs of misdiagnosis or delayed diagnosis down the line.
Many NHS Trusts want to be able to access subspecialty reporting, but struggle when their in-house radiology team doesn’t have expertise in particular specialties. At Hexarad, we are seeing increasing demand for our subspecialty teleradiology network, which connects hospitals with a pool of expert radiologists across all major subspecialties. Whether you need MSK radiology reporting for a complex sports injury MRI, neuroradiology services for intricate brain scans, or paediatric radiology reports for a children’s hospital, we can provide a subspecialist report for you.
By leveraging teleradiology, even smaller NHS Trusts and hospitals can access a consultant radiologist’s expert second opinion on a tricky oncology case or have an out-of-hours trauma scan read by an on-call MSK specialist without needing to wait for a referral.
A consultant-led radiology reporting model also means that experienced consultants are responsible for the reports, adhering to stringent quality standards. Subspecialist teams often implement peer review, double-reading of certain high-stakes cases, and continuous education – all of which reinforce patient safety and diagnostic consistency. By having subspecialists involved in protocol development and discrepancy reviews, teleradiology teams can maintain the same (or even higher) level of governance as an in-house department.
Teleradiology can also support the NHS team to focus on their own subspeciality reporting by mopping up the more general work.
Ensuring Quality, Safety and Efficiency
In the UK, consultant-led teleradiology subspecialty reporting models are working to enhance both NHS and private providers’ imaging services. A key advantage is 24/7 radiology reporting coverage teleradiology can provide. This around-the-clock availability is vital for emergency cases and has been critical when it comes to reducing NHS radiology backlogs, as scans can be read overnight to catch up with daytime demand.
Workforce shortages have led to an increased reliance on teleradiology support. The Royal College of Radiologists has highlighted a 31% shortfall of consultant radiologists nationally, contributing to significant reporting delays. In 2024, NHS hospitals had to outsource reporting for hundreds of thousands of scans due to insufficient staffing; nearly 976,000 imaging studies in England were not reported within the 1-month target timeframe, the highest number on record. These figures underscore an urgent need for more strategic use of teleradiology, particularly when it comes to subspecialists. Trusts can utilise teleradiology services to access subspecialty reporting expertise where needed, or increase local subspeciality reporting by allowing general work to be outsourced. This hybrid approach cuts down delays and reduces overall outsourcing spend, delivering better value for Trusts and patients alike.
From an operational standpoint, partnering with a subspecialty teleradiology service adds resilience and flexibility. Hospitals can scale their reporting capacity on demand – for instance, handling a sudden influx of oncology scans from a cancer screening program or addressing staff shortages due to leave or illness. OptiRad’s intelligent outsourcing approach helps to streamline workflow, automatically routing cases to the appropriate subspecialist. This ensures optimal resource utilisation while maintaining consistent quality standards. By integrating advanced workflow management with expert reporting, departments can maintain service continuity without compromising diagnostic excellence.
To summarise, a holistic approach to consultant-led teleradiology model designed and delivered by radiologists with deep domain knowledge delivers multiple advantages:
Higher Diagnostic Accuracy: Each scan is interpreted by a radiologist with domain-specific expertise, leading to more accurate and detailed reports. This means critical findings in cancer imaging are less likely to be missed or misinterpreted.
Robust Clinical Governance: Subspecialty reporting services operate with structured protocols, peer review systems, and consultant oversight, reinforcing accountability and quality. Having senior specialists involved in every report upholds high standards and ensures patient safety through correct diagnoses and appropriate recommendations.
Operational Resilience: With 24/7 subspecialist availability, hospitals gain a safety net for surges in volume or out-of-hours emergencies. Teleradiology can mitigate the impact of staff shortages and reduce burnout by sharing workload, thus maintaining service continuity even under pressure.
Cost Efficiency: Using consultant-led teleradiology judiciously can be cost-effective. It helps avoid the hidden costs of diagnostic errors or delayed reports (such as prolonged hospital stays or repeated tests). OptiRad's platform enhances this efficiency by intelligently matching cases with the most appropriate subspecialists, reducing turnaround times and ensuring optimal resource allocation. Rather than investing in full-time specialists for every field, healthcare providers can access subspecialty radiology reports on demand through OptiRad's streamlined workflow management. This “pay-as-you-go” specialist support combined with intelligent case routing and real-time capacity management, optimises resource use and can alleviate budget constraints while still delivering expert care.
Combining Advanced Imaging with Expert Reporting
Advances in cancer imaging offer new possibilities for earlier detection, precise staging, and improved disease monitoring. To fully realise these benefits for patients, we must match technological progress with interpretative excellence.
Teleradiology subspecialty reporting provides a practical solution by ensuring that every whole-body MRI (WB-MRI) and complex scan is reviewed by the right expert – either locally at the NHS Trust or with a Teleradiology partner. This approach enhances diagnostic accuracy, builds clinical confidence, and supports multidisciplinary cancer teams in making informed decisions.
For Trust leadership, radiology managers, and clinical directors, this translates into a service that is reliable, safe, and future-proof. It supports your teams in delivering timely, accurate diagnoses – a cornerstone of effective cancer care – while also addressing systemic challenges like workforce shortages and increasing demand.
As cancer imaging evolves, embracing subspecialist expertise and modern reporting models will be key. Whether through an in-house team of experts or consultant-led teleradiology partnerships, the goal remains the same: to provide patients with the best possible imaging outcomes.