Are Radiology Departments Ready for the Current Underlying Obesity Pandemic? A Narrative Review

The COVID-19 pandemic exposed critical vulnerabilities in healthcare systems, forcing radiology departments to rapidly adapt their infrastructure, workflows, and diagnostic practices. In contrast, obesity represents a chronic and growing global pandemic affecting more than one billion people worldwide. This review examines whether radiology departments are adequately prepared to meet the technical, operational, and safety challenges associated with imaging patients with obesity.

A narrative review of the literature was conducted to evaluate the impact of obesity on diagnostic imaging and interventional radiology. Key topics included equipment limitations, image quality, radiation dose optimization, patient and staff safety, workflow efficiency, and procedural challenges.

Obesity affects virtually every stage of the radiological workflow. Technical limitations include gantry size restrictions, table weight limits, and difficulties in patient positioning. Increased tissue attenuation frequently requires higher radiation exposures and can reduce image quality through increased noise, photon starvation, truncation artifacts, and decreased contrast resolution. MRI examinations are further constrained by bore dimensions and specific absorption rate limits. In interventional radiology, obesity is associated with more challenging vascular access, longer procedure times, increased operator radiation exposure, and higher complication rates. Operationally, these patients often require extended appointment slots, specialized transfer equipment, and trained personnel, placing additional demands on departmental resources and potentially contributing to inequities in access to imaging services.

The obesity pandemic poses substantial technical, safety, diagnostic, and operational challenges for radiology departments. Addressing these issues requires investment in obesity-adapted equipment, optimized imaging protocols, specialized staff training, and workflow redesign to ensure safe, effective, and equitable imaging care for this rapidly expanding patient population.