Radiology Reimagined: Interoperability and Lessons Learned from the Imaging AI in Practice Demonstration

The Radiology Reimagined demonstration, formerly known as Imaging AI in Practice, is presented at the Radiological Society of North America (RSNA) Annual Meeting. It highlights how interoperability and semantic standards can facilitate the integration of artificial intelligence (AI) into radiology workflows. This integration encompasses examination ordering, scheduling, protocoling, image acquisition, examination interpretation, reporting, results communication, follow-up, and billing. Since 2020, Radiology Reimagined has become a prominent feature of the RSNA Annual Meeting, showcasing AI's role in clinical imaging workflows. The demonstration fosters collaboration between radiology and industry vendor partners, promoting the adoption of standards such as Digital Imaging and Communications in Medicine, Health Level 7 Fast Healthcare Interoperability Resources (FHIR), and Integrating the Healthcare Enterprise profiles. Realistic clinical scenarios demonstrate the utility and challenges of integrating AI tools into point-of-care systems. The complexity of Radiology Reimagined scenarios has increased, from simple pulmonary nodule and intracranial hemorrhage detection in 2020 to prostate MRI interpretation and amyloid-related imaging abnormality detection in 2024. Each year, more than 20 unique vendor partners participate, progressively incorporating new standards such as Integrated Multimedia Reporting in 2023 and improved support for FHIRcast (which synchronizes health care applications in real time) in 2024. Participants learn how to facilitate interoperability and integrate software into their clinical workflows, with an emphasis on practical advice and key considerations. Future iterations of the demonstration will aim to expand attendee engagement, formalize quantitative feedback, and broaden the use of emerging standards. Videos of the annual demonstrations are available on the RSNA website.