Clinical Implementation of Opportunistic Screening for Osteoporosis.
Authors
Affiliations (2)
Affiliations (2)
- Department of Radiology, NYU Grossman School of Medicine, 660 First Avenue, New York, NY, USA 10016.
- Department of Radiology, UNC at Chapel Hill School of Medicine, 101 Manning Drive Chapel Hill, NC, USA 27514.
Abstract
Opportunistic screening leverages existing imaging examinations performed for unrelated routine clinical indications to systematically extract quantitative biomarkers. Artificial intelligence tools have made deployment at scale increasingly feasible. However, the pathway from a validated algorithm to a functioning clinical program remains poorly defined, and prospective implementation at scale is uncommon. Successful deployment requires coordinated engagement from radiologists, information technology and operational teams, and clinical care teams, each facing distinct decisions that determine whether a program functions reliably and delivers patient benefit. This article presents a practical framework for opportunistic screening implementation organized around these three stakeholder groups. We apply this framework to opportunistic CT osteoporosis screening, drawing on our experience developing such a program at a large academic medical center. The framework presented is intended to be broadly applicable across opportunistic screening applications as the field moves from algorithmic validation toward clinical translation.