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  Title	How radiologists are tackling family violence, climate change and grief
  ID	23202803
  External ID	92f241751fa928aadc18e944f8005c38
  Author	Ruth Armstrong
  Published Date	Nov. 6, 2025, 2:40 a.m.
  Summary	Introduction by Croakey: In her final article for the Croakey Conference News Service on the recent Annual Scientific Meeting of
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  URL	https://www.croakey.org/how-radiologists-are-tackling-family-violence-climate-change-and-grief
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  Content ID	30966668
  Key	a2f796ff-fe42-47c6-ad40-9bf85f6c5c3e
  Content	Introduction by Croakey: In her final article for the Croakey Conference News Service on the recent Annual Scientific Meeting of the Royal Australian and New Zealand College of Radiologists, Marie McInerney digs deeper into the topics raised in a wide-ranging session of the meeting that was inspired by the classical elements of earth, water, fire, air, and spirit. Speakers at the session encouraged delegates to think outside of the (light!) box on issues as diverse as family violence, the environment, and alternatives to autopsy for grieving families. Don't miss the accompanying interviews, and follow the rest of our coverage, here. Marie McInerney writes: It might take a lot to get 'Hephaestus, the divine blacksmith' into a conference session, but doing so illustrated the big picture thinking at the recent Royal Australian and New Zealand College of Radiologists (RANZCR) annual scientific meeting. A standout session focused on radiology issues through the classical elements: earth, water, fire, air, and spirit. 'These elements have been used for centuries to describe the natural forces that shape our world,' conference convener Dr Rose Thomas told participants in the session. 'But today they provide a way to think about the forces shaping radiology and the ones we must understand, balance and lead,' she said. The session prompted discussions from international speakers that ranged from addressing radiology's significant carbon emissions, early detection of family violence, compassionate post-mortem examinations, and the role of radiation in the natural world, including the discovery that sea turtles suffer decompression sickness, or 'the bends'. See below for discussions and interviews, as well as social media posts on other presentations. Click here also for our earlier story on artificial intelligence in radiology. Dr Rose Thomas introducing the session. Copyright Kirkland Photography On the frontline for family violence Associate Professor Bharti Khurana, an emergency radiologist and faculty member at Harvard Medical School, wants radiologists to be able to step up as effective frontline actors in detecting and preventing intimate partner violence (IPV). Radiologists, she said, can see the stigmata of injuries, past as well as current, and can define various injury patterns, including potential give-away facial and defensive injuries, which could lead to interventions that are literally life-saving. 'Ultimately, we want to save lives and prevent injuries through early diagnosis. And yes, the radiologist is indeed the key player here,' she told the ASM. Khurana, who is the founder and director of the Trauma Imaging Research and Innovation Center at Brigham and Women's Hospital in Massachusetts, told Croakey about one of her most graphic cases, a woman who was first injured and imaged when she was 25 and later came to see her aged 38. 'In between she had 68 radiologic studies – not just musculoskeletal, but cardiac [and others] because there are so many adverse effects of domestic violence,' she said. A number of them, on their own or seen as a pattern, could have been a trigger for reporting abuse. But she said abuse can be missed for many reasons, including that clinicians are too busy to check properly, presume patients are able to advocate for themselves, or worry about patient confidentiality and safety. Other barriers can include a reluctance or fear by victim survivors to disclose abuse, limited training of healthcare workers to recognise warning signs, time constraints, particularly in emergency or urgent care settings, and a lack of longitudinal relationships between patients and providers. Nonetheless, Khurana said, many survivors of IPV trust their healthcare providers and may share their stories before they reach out to social workers or law agencies. Therefore, she has written, 'initiating discussions about IPV in healthcare settings is crucial and potentially a matter of life and death'. Dr Bharti Khurana. Image copyright Kirkland Photography With that in mind, Khurana recently led the development of the automated intimate partner violence risk support (AIRS) system, an algorithm that identifies victims of IPV earlier and more accurately. It uses artificial intelligence (AI) to predict a patient's risk, connect victims with resources and support and empower clinicians to discuss IPV with more nuance. 'It's not only identifying patients who are at risk for intimate partner violence, giving quantified risk probability for every patient at the point of care, but it's also coming up with caring conversations, how to talk to these patients, and guides for the patients,' she said. 'This is a time where we can change the world of radiology with AI…to identify and transform imaging into healing and empowerment,' she said. Further reading: Imaging of intimate partner violence, from the American Journal of Radiology special series on emergency radiology Watch the interview Dr Bharti Khurana, founder and director of the Trauma Imaging Research and Innovation Center at Brigham and Women's Hospital in Massachusetts, spoke to Croakey about how radiologists can play a crucial role in early detection and reporting of intimate partner violence. Cutting radiology's carbon footprint Professor Andrea Rockall admits it can be difficult for individuals and individual services or sites to address the big contributors to radiology's significant carbon footprint, such as optimising building infrastructure, buying green energy and influencing supply chains. But she says people can make meaningful change in their daily practices and routines. 'If you scale that up across the globe, the impact is significant,' she told #RANZCR2025. Rockall is Clinical Chair of Radiology at Imperial College in London, and a consultant radiologist at Imperial College Healthcare NHS Trust and The Royal Marsden Hospital. She is also coauthor of a position paper from a range of organisations and colleges, including RANZCR, urging impactful and measurable changes in radiology to mitigate its environmental impact. The paper calls for climate literacy to be added to radiology training programs, and more research to understand and measure the environmental impact of radiological services and inform mitigation, adaptation, and monitoring efforts. It says deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy use, and the circular economy, through nine priority actions. It is, she says, her 'passion project' as the world now witnesses the escalating impacts on health of climate change. Research shows that the health sectors of the United States, Australia, England, and Canada emit a combined 748 million metric tons of carbon dioxide annually. If these sectors were joined together as a single, independent nation, that nation would rank seventh in the world for greenhouse gas emissions. Radiology plays a big part in that count, led by its 'workhorses', MRI and CT scanners. Diagnostic services have been shown to account for around nine percent of healthcare emissions in New South Wales, while four MRI and three CT scanners alone were attributed to four percent of the total energy consumption of one un-named hospital. Rockall has urged climate literacy to be added to radiology training and for radiologists to justify the sustainability of their practices, 'akin to how they justify radiation exposure to patients'. Professor Andrea Rockall on sustainability. Image courtesy Marie McInerney She highlighted how the use of smart monitoring tools can help to mitigate energy consumption related to heating, ventilation and air-conditioning (HVAC), lighting, and machine 'on-time' — with many such measures actually saving money as well as emissions. 'Switching off is the easiest [action],' she said. That may require sophisticated monitoring of machinery and have to take safety into account, but she said the introduction of automated 'switch off' software at the Royal Marsden has saved around 'half a million pounds a year'. Rockall also raised the need to stop residual unwanted iodinated contrast media from being disposed of into the normal wastewater system or clinical waste stream, and for re-educating staff on the use of correct waste disposal streams within an imaging department. Rockall said she had long been interested in the environment, recycling and energy saving, 'switching off the lights at home and what have you'. 'I've just carried that through in my professional career, but more recently…with climate change upon us, it's become much more urgent, and I've now decided to make quite a focus on sustainability.' Watch the interview Professor Andrea Rockall, Clinical Chair of Radiology at the Imperial College London and a consultant radiologist at Imperial College Healthcare NHS Trust and The Royal Marsden Hospital, spoke to Croakey about how everyday changes in radiology practice could significantly reduce the profession's carbon footprint. Gap in care UK clinical paediatric radiologist Associate Professor Susan Shelmerdine believes that increased access to post-mortem imaging has potential to relieve some of the grief experienced by parents when babies are stillborn or have miscarried. It's an issue that's been raised also in Australia, with a study published earlier this year highlighting post-mortem imaging as 'a gap in care for almost 3,000 Australian families who experience the heartbreak of stillbirth each year'. Shelmerdine, a consultant paediatric radiologist and post-doctoral AI academic based in London, has welcomed the general shift away, over recent decades, from autopsies, which she said can be invasive and emotionally distressing for families, to post-mortem imaging, using computed tomography and magnetic resonance imaging. Shelmerdine told Croakey at #RANZCR2025 that post-mortem imaging for children is used more as an adjunct to autopsies, to help uncover more information when they have died unexpectedly or if there is any sign of child abuse, which then would be a safeguarding issue for any remaining children in the family. Where she would like to see the practice expanded is for babies who have died through stillbirths and miscarriages, where currently autopsy is the only option. Bereaved families want answers 'but they don't want it at the risk of having to undergo a second traumatic experience', she said. 'Either you have no answers, or you go for the most dramatic, traumatic, emotionally distressing option, and there's no in between. Whereas imaging can provide that 'in between', and in some cases even give you the answer you want.' Shelmerdine said there is in fact no legal requirement to investigate these deaths, and they aren't given a death certificate, 'but, of course, parents who have lost a baby really want to know why that's happened, they want answers'. Many may be blaming themselves for the death of an unborn child, worrying that it might have been caused by something a mother ate or activity she did. Post-mortem imaging can offer insights into whether conditions are likely to recur in future pregnancies or, when findings are normal, provide much needed reassurance to parents that the loss was not their fault, she said. 'A lot of the time we can find an answer, or even if we don't, the reassurance to the parents is just amazing.' Susan Shelmerdine. Bereaved families need answers. Image Copyright Kirkland Photography Shelmerdine raised the issue at #RANZCR2025 in the hope of spreading the word about the benefits of such imaging, which she said remain 'little known'. Talking about death remains taboo for many, and health professionals may not want to invite such conversations, 'because they're worried about upsetting people, when actually there's a huge community of people who are in such pain, and who really wish they had some closure and really want to talk about it', she said. It is also an important option for faiths, such as Islam and Judaism, where autopsies may raise extra sensitivities. Despite these benefits, postmortem imaging is not easily available or accessible and there is some debate amongst radiologists regarding the best practice and optimal protocols for performing such studies. Shelmerdine said there are currently few pathways to learn the skill, and post-mortem imaging is not part of standard NHS care – instead it is often funded by local authorities or directly by bereaved families. Queensland's Mater Research senior research fellow Dr Siobhan Loughnan, who led the Stillbirth CRE study in partnership with RANZCR, reported that accurately identifying the causes of stillbirth is vital in guiding future pregnancy care for families. 'While conventional autopsy is the gold standard for determining causes, less invasive options like post mortem imaging (PMI) can offer value and may be appropriate and acceptable to parents who decline autopsy,' she said in a Mater Research report. Australia's National Stillbirth Action Plan advocates for greater use of PMI, alongside efforts to train more radiologists. The 2024 Care Around Stillbirth and Neonatal Death (CASaND) Clinical Practice Guideline, which was published by the Stillbirth CRE and Perinatal Society of Australia and New Zealand (PSANZ) supports PMI as a diagnostic tool, yet Mater Research said little is known about its uptake. Watch the interview Associate Professor Susan Shelmerdine, a consultant paediatric radiologist and post-doctoral AI academic based in London, speaks to Croakey at #RANZCR2025 about the need for compassionate post-mortem imaging, and the impact of AI on radiology, particularly its use in children's imaging, where there is both promise and the risk of fatal errors. From across the conference on social media Radiation oncology Interventional Radiology and Interventional Neuroradiology Other topics Selfies and celebrations Marie McInerney attended the conference on 24 October, providing live coverage via social media, and reports for Croakey. Bookmark this link for all her stories from #RANZCR2025 for the Croakey Conference News Service.
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