Abstract
Objectives
Gender equity in medicine remains a topic of increasing attention. The aim was to investigate if gender influences the radiology profession, with a focus on career progression, leadership roles, work-life balance, research activity and perceived barriers.
Materials and methods
An anonymous online survey consisting of 22 questions was distributed by the European Society of Radiology (ESR) to its members between October and December 2024. The survey covered demographics, work schedules, family responsibilities, career development, leadership roles, research involvement, and perceived personal experiences. Quantitative data were analyzed using descriptive statistics, chi-square test, and rate differences with confidence intervals. Open-ended responses were explored qualitatively using thematic analysis.
Results
Among 830 respondents, 657 completed the questionnaire (63.3% female, 35.3% male, 1.3% others). Women more frequently reported caregiving responsibilities beyond childcare (4.1% vs 3%), longer parental leave (46.2% vs 21.5%), and experiences of harassing behaviors at work. Men held a higher proportion of leadership roles (33.2% vs 25.2%). Respondents involved in research were more likely to work > 30% extra hours (47.2% vs 29.0%). Although research activity rates were similar across genders, women more often reported barriers to attending conferences and a lack of protected research time. Career fulfillment increased with age among men but decreased among women. Gender was considered a career disadvantage by 44.5% of women versus 9.5% of men.
Conclusion
The survey reveals perceived gender disparities in radiology, particularly in leadership access, work conditions, and career satisfaction. Addressing structural barriers and promoting supportive workplace policies are essential to achieving true gender equity in the field.
Critical relevance statement
Despite improvements in the last few decades, gender inequity remains present in radiology. Variability between geographical regions suggests that key critical areas can be addressed to promote improvement and support a more equitable professional environment.
Key Points
Perceived gender disparities in radiology are present across career progression, leadership roles, and work-life balance.
Women were significantly more likely than men to perceive gender as a career disadvantage (44.5% vs 9.5%; p < 0.0001 35.0% [95% CI: 28.9 to 41.1]). They reported slightly higher caregiving responsibilities and longer parental leave.
Structural inequalities impact gender equity in radiology, requiring targeted institutional and cultural changes.
Graphical Abstract
Keywords: Radiology, Gender equity, Job satisfaction, Work-life balance, Leadership
Introduction
Over the past decade, discussions on equity, diversity, and inclusion (EDI) have gained momentum in radiology and other medical specialties, driven by societal movements, institutional initiatives, and growing awareness of disparities in access, representation, and opportunity [1–3]. Key EDI factors include gender distribution, leadership, and authorship, as well as the impact of ethnicity and origin on careers. Marked cross-country disparities highlight the need for targeted EDI analyses in European radiology [4]. Despite increasing attention, data on EDI within European radiology remain limited and fragmented, with most of the current evidence coming from non-European countries [5]. Some European medical societies have been implementing initiatives to increase evidence and awareness on these topics [6].
The European Society of Radiology (ESR), with its large and diverse membership base, represents a unique opportunity for multifaceted data collection [7]. The survey explores the perceived influence of gender on career progression, workplace interactions, and professional experiences in radiology research, while identifying key areas for improvement to support greater gender balance and inclusivity.
Methods
Survey design and distribution
The study received approval from the Institutional Review Board of the Fondazione Policlinico Universitario “A. Gemelli,” Rome, Italy (Lazio Area 3, ID 6866, 04.10.2024).
The survey was developed by six radiologists (2 males and 4 females; aged 37–45 years) working in academic hospitals across Europe, assisted by an experienced biostatistician. When possible, questions were based on existing surveys and articles [8–10]. The survey examined gender equity in radiology across demographics, family responsibilities, work conditions, career advancement, perceived bias, and overall satisfaction. The final version was reviewed and approved by the ESR Research Committee and by the Board of Directors.
The final 22-question survey, including multiple-choice and open-ended responses, was tested for clarity by 10 radiologists and 5 non-radiologists (medical doctors or radiographers), and refined accordingly. It was implemented in English using SurveyMonkey (www.surveymonkey.com) and distributed via email by the ESR to all its members between 1 October 2024 and 9 December 2024. Data were collected anonymously. The initial dissemination email was sent to 106,775 recipients, followed by a reminder to 60,856 non-openers on 4 December. The questionnaire is included in the Supplementary Material (SM).
Data analysis
Data were summarized as absolute counts and percentages. Age was reported as median and range and compared between groups using the Mann–Whitney U test.
In order to ensure subgroups with a sufficient size for sub-analyses, countries were grouped following the United Nations geographical regions [11].
Cross-tabulations were performed with gender, age and geographical regions to analyze associations between items and these three factors; the chi-square test was used for determining statistical significance of differences. Group comparisons were assessed using absolute rate differences with 95% confidence intervals (CIs) to evaluate statistical significance and the estimate precision. Due to the low number of non-binary participants, subgroup analysis included only female or male participants. A two-sided p-value < 0.05 was considered statistically significant. Statistical analyses were performed using IBM-SPSS Statistics for Windows, v.28.0 (IBM Corp).
Open-ended responses were analyzed using ATLAS.ti (www.atlasti.com, Scientific Software Development GmbH).
Results
General description
A total of 830 responders participated in the survey. Of those, 657 completed the entire questionnaire (79.2%). Partial responses were excluded.
Among the respondents, 63.3% identified as female (n = 416), 35.3% as male (n = 232), and 1.3% as other (n = 9) (4 “non-binary,” 2 “prefer not to disclose,” and 3 “other”). The median age of participants was 41 years (range: 21–77), higher in male respondents (43 years, range: 22–77) than in females (40 years, range: 21–75; p < 0.001). The geographical distribution of participants is reported in Fig. 1. A complete list of participating countries is provided in Table S1 in the SM.
Fig. 1.
Geographical distribution of participants. Most participants lived and worked in Europe (68.5%) or Asia (17.1%). Other represented regions were North America (5.4%), Africa (4.6%), South America (2.8%), Oceania (1.4%), and Central America (0.2%)
Most respondents were employed in University Hospitals or research centers (64.7%), followed by Public Hospitals (29.2%), Private Hospitals (21.0%), or other types of healthcare facilities (5.6%).
Most of the participants were clinical radiologists (31.3%), followed by radiologists in leadership positions (26.6%), and radiologists in training/fellows (17.7%) (Table S2 in SM). Subspecialities of radiology practice are shown in Table 1.
Table 1.
Subspecialty/area of practice
| Subspecialty/area of practice | N | % |
|---|---|---|
| Breast radiology | 125 | 19.0% |
| Cardiac and vascular radiology | 69 | 10.5% |
| Chest radiology/thoracic imaging | 48 | 7.3% |
| Emergency radiology | 33 | 5.0% |
| Gastrointestinal and abdominal radiology | 109 | 16.6% |
| Head and neck radiology | 33 | 5.0% |
| Interventional radiology | 71 | 10.8% |
| Medical imaging informatics | 6 | 0.9% |
| Musculoskeletal radiology | 55 | 8.4% |
| Neuroradiology | 103 | 15.7% |
| Oncologic imaging | 61 | 9.3% |
| Pediatric radiology | 54 | 8.2% |
| Urogenital radiology | 59 | 9.0% |
| General radiology/no specific subspecialty | 149 | 22.7% |
General radiology was the most common area of practice (23.0%), followed by breast (19.0%), gastrointestinal/abdominal (16.5%), and neuroradiology (15.9%)
Overall, 65.4% of respondents were engaged in research activities, with no significant gender difference (68.1% men vs 63.9% women, p = 0.28).
Among the 648 respondents, 69.1% studied and currently worked in their birth country (68.8% of women, 69.8% of men, p = 0.84, 1.1% [95% CI: 0.0–8.5]), 11.0% studied in their birth country and then moved abroad (12.7% of women, 7.8% of men, p = 0.069, 5.0% [95% CI: 0.3–9.7]), 13.0% studied and worked in their birth country but had had a fellowship or training period abroad (12.7% of women, 13.4% of men, p = 0.92, 0.6% [95% CI: 0.0–6.0]), 4.5% both studied and worked abroad (4.6% of women, 4.3% of men, p = 1.00, 0.3% [95% CI: 0.0–3.6]), and 2.5% studied abroad but currently worked in their birth country (1.2% of women, 4.7% of men, p = 0.012, 3.5% [95% CI: 0.6–6.5]).
Private life
44.4% of the respondents reported not having children, 55.6% had at least one child. Associations between current professional role and parenthood are in Table S3 in the SM.
The difference in caregiving roles beyond childcare between women and men was minor: 4.1% of women provided full-time care compared to 3.0% of men (p = 0.48, 1.1% [95% CI: −2.3; 3.9]). Additionally, 15.4% of women shared caregiving responsibilities, compared to 9.9% of men (p = 0.049, 5.5% [95% CI: 0; 10.5]). Further childcare support details are in the SM.
Family-related leaves were more common and longer for women (46.2% vs 21.5%) (Fig. 2). One third of the respondents reported no difficulties upon returning to work (Fig. S1). However, after a family-related leave, women more frequently reported exclusion from new tasks or projects (13.9% vs 3.9% in men, p < 0.001), loss of responsibilities (6.0% vs 0.4%, p < 0.001), and difficulty in resuming their previous role (4.6% vs 0.9%, p = 0.006), regardless of the duration of absence.
Fig. 2.
Family-related leaves. The figure shows how many respondents required any kind of leave during their career divided by gender. Parental leave was more common among women (46.2%) than men (21.5%; p < 0.001, difference 24.7% [95% CI: 17.3–31.5]). Conversely, more men (58.6%) than women (43.0%) reported never having needed to take leave (p < 0.001, difference 15.6% [95% CI: 7.6–23.3])
Timetable and working hours
Full-time work with night shifts was the most reported schedule (43.2%), followed by full-time without night shifts (38.6%). Association with gender and parenthood, and responses from the most represented geographical regions are shown in the SM.
475 out of 648 (73.3%) reported working beyond their official schedule, with similar proportions of those with and without children (55.6% vs 55.5%, p = 0.98). Among women, the highest proportion with more than 30% additional working hours was observed in the youngest (≤ 35 years, 41.8%) and oldest (≥ 51 years, 47.4%) age groups. In contrast, men showed the lowest percentage in the youngest group (≤ 35 years, 32.8%), with progressively higher values in older age groups, peaking at 45.9% in those aged ≥ 51 years.
Individuals actively engaged in research were more likely to work overtime (Fig. 3). Data on whether the research was conducted or included during working hours are provided in the SM.
Fig. 3.
Research activity and overtime work. The pie charts show the frequency of overtime work in respondents participating versus not participating in research activities. Among respondents involved in research, 47.2% reported working more than 30% additional hours beyond their official schedule, compared to 29.0% of those not engaged in research (p < 0.001, 18.2% [10.4; 25.5])
Career
Gender distribution varied across the different specializations, with a higher female representation in diagnostic radiology compared with interventional radiology. Details in SM.
While most respondents (75.5%) stated that gender did not play a role in their choice of subspecialty, 18.3% of women reported that their gender influenced their choice, compared to 1.7% of men (p < 0.001, 16.6% [95% CI: 12.3; 20.7]). Most of these women selected breast imaging and pediatric imaging as their subspecialty.
Women were significantly more likely than men to perceive gender as a disadvantage in their careers (44.5% vs 9.5%; p < 0.0001 35.0% [95% CI: 28.9 to 41.1]), with variability between regions. Full data are available in the SM.
Reduced possibility to attend on-site conferences (71.8%) was not significantly affected by gender (p = 0.24). Limited funding (49.8%) and organizational constraints (48.0%) were the main barriers. No significant geographical region differences were observed (p = 1.0). Details are in the SM.
Women published and led grants less than men (data are reported in Tables 2 and 3).
Table 2.
Publication data
| Category | Total N (%) | Female N (%) | Male N (%) |
|---|---|---|---|
| Published at least one article in a peer-reviewed journal | 486 (77.8%) | 300 (78.1%) | 177 (78.3%) |
| Published in the last 12 months | 313 (50.1%) | 190 (49.4%) | 119 (52.7%) |
| Published more than 12 months ago | 312 (49.9%) | 194 (50.6%) | 107 (47.3%) |
| Published as first or last author | 459 (73.5%) | 275 (71.7%) | 173 (76.7%) |
| Never published as first or last author | 165 (26.5%) | 109 (28.3%) | 52 (23.3%) |
The table reports responses related to publication in peer-reviewed journals and authorship, by gender. Men were significantly more likely to have published as first or last authors (p = 0.032; difference 8.5% [95% CI: 1.2–15.7]), and this was the only statistically significant difference observed
Table 3.
Grants acquisition stratified by age groups
| Age groups | Have you acquired grants in the last 5 years? | Female N (%) | Male N (%) |
|---|---|---|---|
| ≤ 35 | Yes, as PI or co-PI | 9 (6.2%) | 5 (8.2%) |
| Yes, as part of a team | 24 (14.4%) | 15 (24.6%) | |
| No | 116 (79.5%) | 41 (67.2%) | |
| Total | 146 (100.0%) | 61 (100.0%) | |
| 36–40 | Yes, as PI or co-PI | 18 (25.0%) | 3 (8.8%) |
| Yes, as part of a team | 12 (16.7%) | 6 (17.6%) | |
| No | 42 (58.3%) | 25 (73.5%) | |
| Total | 72 (100.0%) | 34 (100.0%) | |
| 41–50 | Yes, as PI or co-PI | 20 (19.4%) | 16 (30.8%) |
| Yes, as part of a team | 18 (17.5%) | 9 (17.3%) | |
| No | 65 (63.1%) | 27 (51.9%) | |
| Total | 103 (100.0%) | 52 (100.0%) | |
| ≥ 51 | Yes, as PI or co-PI | 19 (20.0%) | 19 (22.4%) |
| Yes, as part of a team | 16 (16.8%) | 13 (15.3%) | |
| No | 60 (63.2%) | 53 (62.4%) | |
| Total | 95 (100.0%) | 85 (100.0%) | |
| Total | Yes, as PI or co-PI | 66 (15.9%) | 43 (18.5%) |
| Yes, as part of a team | 67 (16.1%) | 43 (18.5%) | |
| No | 283 (68.0%) | 146 (62.9%) | |
| Total | 416 (100.0%) | 232 (100.0%) |
Grant acquisition increases with age, with younger researchers (≤ 35) having the lowest success rates. Across all age groups, women report a higher percentage of not acquiring grants compared to men (p = 0.19, 5.1% [−2.4; 12.8])
Working environment
Gender distribution of physician staff in the departments is reported in Table 4. Details on the distribution by geographical region are provided in the SM.
Table 4.
Gender distribution of physician staff and leadership roles within the department
| Category | N (%) |
|---|---|
| Department gender composition | |
| Fairly balanced | 259 (39.9%) |
| Predominantly female (> 60%) | 215 (33.2%) |
| Predominantly male (> 60%) | 174 (26.9) |
| Leadership roles | |
| Formal position (men) | 215 (33.2%) |
| Formal position (women) | 163 (25.2%) |
| Informal position (men) | 115 (17.7%) |
| Informal position (women) | 150 (23.1%) |
The majority of departments reported a fairly balanced gender distribution. Formal position refers to a role officially recognized through titles or appointments; informal position is one that is not officially acknowledged by any title or formal nomination. Men were more likely to occupy formal senior positions (33.2%), while women were more likely to occupy informal senior positions (23.1% compared to 17.7% of men, p = 0.31, 5.4% [95% CI: −1.0%; 11.8])
A prevalence of male heads of the department (69.9%) was found, while female department heads made up 29.2% (p ≤ 0.0001, 40.7% [95% CI: 35.7 to 45.7]). Gender distribution of leadership positions within the department is reported in Table 4. Leadership positions in extracurricular activities (i.e., member of Editorial Board of a peer-reviewed journal, board member of a subspecialty society or task force, etcetera) were predominantly held by men (49.6% vs 40.1%, p = 0.025).
Interest and aspiration in occupying a leading role within the department and/or in extracurricular activities were significantly (p < 0.001, 14.4% [95% CI: 7.0 to 21.9]) higher among women and in the youngest age groups, progressively declining with age (Fig. 4).
Fig. 4.
Interest in senior/leading positions. The percentage of people interested in senior positions in the department (A) and in leading positions in extracurricular activities (B) is presented stratified by age group (x-axis) and gender. F, female; M, male
Personal experience
A higher percentage of females (57.2%) reported being asked information regarding their private life during job interviews compared to males (31.5%) (p < 0.001, 25.7% [95% CI: 17.8; 33.0]). A significantly higher percentage of females (32.2%) reported being addressed in a less respectful manner multiple times compared to males (5.6%) (p < 0.001, 26.6% [95% CI: 20.9; 31]), more commonly in Western Europe (p = 0.0062). Refer to the SM for the association by geographical regions. In Fig. 5, the data on the experience of harassing behaviors are reported. 1.6% reported experiencing physical/sexual assault.
Fig. 5.
Experience of harassing behavior. The pie charts show how often respondents experienced or observed harassing behavior such as unwanted sexual jokes or remarks, pressure for sexual favors, and sexual assault. Up to 20% of the respondents had “experienced” and/or “observed” forms of harassment or abusive behaviors
The perceived career impact of this situation was negative in 19.3% of females compared to 2.4% males (p < 0.001, 16.9% [95% CI: 12.4; 21.2]). A positive impact was reported by 0.2% of the total participants, male and female.
In relation to achievement of personal career ambitions, the responses correlated with age groups and gender (p < 0.001) (Fig. 6). Perceived career achievement increased with age in men, while women more often reported only partial fulfillment. Career achievement was more often reported by respondents with children than those without (68.9% vs 45.6%, p < 0.0001), without statistically significant gender differences (79.8% vs 46.2%, p = 0.0009 for men and 59.4% vs 42.9%, p = 0.0029 for women). Family-related leave showed no significant association in career achievement (p = 0.20).
Fig. 6.
Perceived career achievement by age group and gender. The graphic shows perceived satisfaction with their career achievement of the respondents stratified by age (x-axis) and gender
Discussion
The results of this survey underline that, despite progress toward gender equality, issues such as limited organizational support and underrepresentation in leadership continue to impact the professional development of female radiologists.
The gender distribution observed in our respondent population reflects the increasing female representation in the radiological workforce worldwide, in line with the literature [4]. The participants were younger than the general radiological workforce (median age 41 years vs 45% over 51 years) [12]. Most of the respondents came from Europe (68.5%) and Asia (17.1%).
11% of respondents moved abroad after graduating in their birth country, with a slight majority of women, suggesting a greater propensity to seek better career opportunities in more favorable geographical regions. Parenthood rates did not differ significantly by gender, though women showed a tendency to have fewer children. Women showed slightly higher shared caregiving than men. In the context of childcare, women were significantly more likely than men to rely on both informal (partner and family) and formal (paid childcare) support. Parental leave was reported more frequently by women (46.2%) than by men (21.5%), with a higher prevalence among those in leadership positions, clinical radiologists, and academic roles. These findings should be interpreted in light of national policy frameworks. Most countries, except the United States, have implemented paid leave policies that have generally expanded over the past two decades, although substantial cross-national variation remains, influencing economic, social, and health outcomes [13–15]. Recent reforms have extended the duration of paternity leave, which still remains shorter than maternity leave but has shown increased uptake [13].
Only 6.4% of respondents reported shared parenting responsibilities, highlighting the need for cultural and policy changes to promote co-parenting, as women still bear most caregiving duties, despite a gradual move toward more gender-balanced roles [16, 17].
Upon returning to work after a family-related leave, the majority of respondents reported unchanged working conditions; however, significant gender differences emerged in reintegration experiences. Women more frequently reported exclusion from new tasks or projects, loss of responsibilities, and difficulties in resuming their previous role, regardless of the duration of absence. These findings are reflected in the qualitative accounts of female participants, who described being “loaded with work upon return,” having duties “reassigned even before leaving,” and experiencing a “lack of support” at both clinical and personal levels. Similar patterns have been reported in other medical and academic settings [18], highlighting the need for active monitoring and institutional policy action.
Most European participants worked full time with night shifts. Individuals engaged in research were more likely to work extra hours. Moreover, both for male and female research activity was found to be excluded from the job plan in most cases, highlighting the widespread issue of lack of protected time for research activities, in line with both European and non-European literature [19, 20].
Parenthood was not associated with differences in research involvement or in work schedule (full time vs part time). This finding contrasts with the existing literature, where child-rearing is more commonly associated with part-time work [5]. However, among full-time workers, those with children were more likely to perform night shifts. Our study did not explore the reasons behind this pattern, which may vary across settings and relate to night shifts offering greater daytime flexibility, local rota structures, staffing shortages, or financial considerations.
Reported working hours varied widely, reflecting geographical differences and the absence of standardized metrics to define radiology workloads, as previously highlighted [12]. The workforce shortage and organizational constraints were also cited by 48% of our participants as a reason for not attending conferences.
In line with previous reports, our findings confirm persistent gender differences across radiological subspecialties. The reasons behind this underrepresentation appear multifactorial. As shown in prior literature, heavy workloads and challenges in achieving work-life balance are among the main deterrents [4, 21], while the presence of effective mentorship has been recognized as a facilitating factor for women’s engagement in traditionally male-dominated specialties [22, 23]. Radiation exposure concerns, historically cited as a key barrier to entering interventional radiology [4], were rarely mentioned by our respondents, suggesting a possible shift in perceptions due to improved safety standards and greater awareness. Participants stated: “I am planning to have a family and children, so I wanted a good work-life balance,” “I was inspired by my female mentors during residency, as well as by a strong desire to address the unique challenges faced by female patients,” and “I thought being an interventional radiologist would be more difficult as a woman.” It is therefore not surprising that a significant proportion of women, predominantly in Europe, perceive their gender as a disadvantage to their career, in line with similar findings previously reported [4, 24, 25].
Most respondents had published at least one article in a peer-reviewed journal (77.8%), contributing as either first or last author (73.5%); with a higher proportion of men holding first or last authorship roles, with no significant differences between men and women. These findings highlight the increasing involvement and contributions of women in radiology research, particularly over the past two decades [23, 26–29]. Promoting gender parity is crucial, both as a matter of equity and to ensure that research agendas encompass issues pertinent to female populations.
Survey data regarding research funding acquisition align with previous evidence showing increased success with age [30] and no significant gender differences observed.
Our findings on gender distribution among physicians and senior departmental roles align with previous reports [4, 23]. Although many departments report a balanced gender environment, especially in Europe, women remain significantly underrepresented in formal senior roles (25.2% in our findings vs 20% reported in the literature) [23] and in leadership positions within extracurricular activities (40.1%), despite equal expressed interest of both women and men in taking on such roles. For instance, the American College of Radiology (ACR) appointed its first female chair of the Board of Chancellors as late as 2018, and only 13.7% of women are part of editorial boards in radiology journals [26, 27].
Women more frequently received questions about their personal lives during interviews, both in Europe and elsewhere, and report experiencing abuse and disrespectful behavior, in line with previous studies, although earlier research showed higher rates (45–10%) than those observed in our cohort (≤ 20%) [5, 31], highlighting the need for targeted education and awareness to address gender-based disrespect. Taken together, the data ultimately converge on the question of perceived career achievement, suggesting that structural and cultural factors continue to shape women’s experiences and advancement.
Most respondents reported having either mostly (35.8%) or partially (26.1%) achieved their career ambitions, with notable gender differences emerging across age groups. Among younger respondents (≤ 35 years), there were no substantial gender disparities in the proportions reporting ‘mostly achieved’ or ‘partially attained,’ but with increasing age, women reported fewer “mostly achieved” and more “partially attained” outcomes, showing an opposite trend to men, and contrary to literature reports of age-stable patterns [31, 32]. Although women reported greater challenges in balancing work and caregiving responsibilities, having children was not associated with lower career satisfaction, and this was true for both women and men.
This study has several limitations. The predominance of European respondents may limit the generalizability of findings to a global radiology workforce. Voluntary participation may have introduced self-selection bias, with individuals more interested in gender-related issues more likely to respond. Gender differences in family-related leave duration may reflect unmeasured factors (e.g., voluntary vs involuntary absence), potentially biasing return-to-work outcomes. The exclusion of income data may have limited the interpretation of some responses. An additional limitation is the use of an original questionnaire. Nevertheless, this is customary in this type of research, and questions were tested for clarity and understandability before distribution. Lastly, the cross-sectional design offers only a snapshot in time and does not allow for assessment of causal relationships or temporal changes in gender disparities.
In conclusion, gender does influence careers in radiology. Despite progress toward gender equality, limited organizational support and underrepresentation in leadership continue to impact the professional trajectories of female radiologists, contributing to self-imposed career limitations and persistent inequities in career progression and academic recognition. These findings provide a foundation for targeted strategies and policies to promote equity and inclusion.
Supplementary information
Acknowledgements
The authors would like to thank Matteo Mancino, MD, and those who tested the survey and are not included as authors.
Abbreviations
- CI
Confidence interval
- EDI
Equity, diversity and inclusion
- ESR
European Society of Radiology
- SM
Supplementary Material
Author contributions
A.D.: conceptualization, data curation, methodology, visualization, project administration, writing original draft, writing review and editing. E.G.: conceptualization, visualization, methodology, critical revision of the manuscript. M.B.: supervision, critical revision of the manuscript. C.G.: visualization, methodology, critical revision of the manuscript. C.P.: methodology, critical revision of the manuscript. A.P.P.: methodology, critical revision of the manuscript. A.v.d.H.: methodology, critical revision of the manuscript. P.A.T.B.: supervision, critical revision of the manuscript. D.G.: data curation, formal analysis, statistical analysis, methodology, visualization. R.M.: conceptualization, methodology, visualization, supervision, critical revision of the manuscript. M.S.: supervision, critical revision of the manuscript. P.C.: conceptualization, data curation, methodology, visualization, supervision, critical revision of the manuscript. All authors read and approved the final manuscript.
Funding
The authors state that this work has not received any funding.
Data availability
The data are not available for sharing to safeguard individual privacy.
Declarations
Ethics approval and consent to participate
The study received approval from the local Ethics Committee of the Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy (Lazio Area 3, ID 6866).
Consent for publication
Not applicable.
Competing interests
A.D.: The author declares that she has no competing interests. E.G.: Deputy editor for Insights into Imaging and, as such, did not participate in the selection or review processes for this article. M.B.: Member of the ESR Board of Directors. C.G.: member of the Scientific Editorial Board of Insights into Imaging and, as such, did not participate in the selection or review processes for this article. C.P.: Deputy editor for Insights into Imaging and, as such, did not participate in the selection or review processes for this article. A.P.P.: member of the Scientific Editorial Board of Insights into Imaging and, as such, did not participate in the selection or review processes for this article. A.v.d.H.: The author declares that she has no competing interests. P.A.T.B.: Grant from Siemens Healthineers and Bracco, EUSOBI board member. D.G.: The author declares that she has no competing interests. R.M.: Grants or contracts from Dutch Research Council, Dutch Cancer Society, EU–EFRO, EU–Eurostars, Medtronic, BD, Koning, Screenpoint Medical, Bayer Healthcare, Siemens Healthineers, SenoMedical; consulting fees from Siemens, Bayer Healthcare, BD, Screenpoint Medical; member and/or advisor for the European Society of Radiology, Dutch Cancer Society, and Oncode Institute. EUSOBI board member. Member of the Advisory Editorial Board of Insights into Imaging and, as such, did not participate in the selection or review processes for this article. M.S.: Consulting fees (paid to institution) from Bracco. P.C.: Grant from Siemens Healthineers, EUSOBI board member; Editor-in-Chief of Insights into Imaging and, as such, did not participate in the selection or review processes for this article.
Footnotes
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Supplementary information
The online version contains supplementary material available at 10.1186/s13244-026-02281-w.
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