Advancing Imaging Through Open Access
Broader access to imaging research is changing how findings are evaluated, shared and applied around the world
International Open Access Week, observed Oct. 19–25, draws attention to efforts to make research freely available worldwide. The 2026 theme, “The Cost of Knowledge,” asks the research community to weigh the financial, human and environmental costs of creating and sustaining knowledge, and the consequences of excluding people from it.
In medical imaging, the question extends beyond whether an article can be read without a subscription. Open access shapes how quickly research circulates, who can evaluate it and whether investigators can reproduce and build on emerging findings.
RSNA entered this evolving publishing landscape in 2024 with Radiology Advances, its first exclusively open-access journal. Led by editor Susanna I. Lee, MD, PhD, the online journal makes content freely available at publication and provides a forum for imaging research.
“Open access facilitates more rapid dissemination of new knowledge, promotes transparency and encourages collaboration,” Dr. Lee said.
Balancing Access, Speed and Scientific Rigor
Broad availability does not lessen the need for rigorous evaluation.
“Readers and reviewers come to RSNA journals expecting quality content that has been vetted for scientific rigor, clinical relevance and veracity,” Dr. Lee said. “Articles published in Radiology Advances undergo peer and editorial review from multiple individuals, analogous to the other subscription RSNA journals.”
For many investigators, open access is no longer optional. Major public funding agencies, including the National Institutes of Health, the European Union and the World Health Organization, require that the research they support be published via open access. Open-access publishing also has the benefit of drawing more attention than work behind paywalls. By extension, it has the potential to generate more citations, article views, downloads and social media posts.
Radiology Advances has also worked to simplify submission and shorten turnaround time. The version of record is typically published in the journal three to five months after manuscript submission.
“This speed benefits authors by getting their work into the public record faster, letting them establish priority on discoveries and build on results sooner,” Dr. Lee said.
That combination of speed and transparency matters in AI investigations, where a model’s performance depends as much on its training data and validation as on the algorithm itself.
“Sharing findings and methods allows researchers to understand how a system was developed, identify its limitations and potential biases and determine whether results are reproducible across institutions and patient populations,” said Yifan Peng, PhD, associate professor of population health sciences and affiliated associate professor of radiology at Weill Cornell Medicine in New York City. “This is essential to move imaging AI from promising research results to reliable clinical applications in radiology.”
According to Dr. Peng, who is also deputy director of the Institute of AI for Digital Health at Weill Cornell, access to methods, code and models helps investigators build on existing work rather than solve the same problems repeatedly.
“Openly sharing these resources also makes it easier for computer scientists, radiologists, engineers and other stakeholders to collaborate across disciplinary boundaries, accelerating both methodological innovation and clinical translation,” Dr. Peng said.
From Research Access to Practice Worldwide
For practicing radiologists and trainees, access can determine whether evidence is available when a clinical or educational question arises.
“Radiologists in private practice, teleradiology or smaller hospitals often lose institutional access when they leave an academic center, just when they become fully responsible for keeping their knowledge current,” said Lisa C. Adams, MD, professor of radiology at the Technical University of Munich and deputy editor of Radiology Advances.
Trainees encounter paywalls regularly, she added, and for colleagues in countries where subscriptions are unaffordable, open access may be the only way to read the research. Timely access matters most in rapidly changing fields such as AI development.
"When a practical question comes up, such as whether a tool was properly validated or whether a change in protocol is supported by evidence, an abstract is usually not enough," Dr. Adams said.
Access to the full article also changes the conversations related to it. Rather than summarizing a paper for a referring clinician or colleague, Dr. Adams said she can simply send it. "Research is much easier to discuss, teach and apply when everyone involved can access it," she said.
Open access also changes who can take part in that exchange.
“Having worked and collaborated with investigators across different countries, I have seen how access to the scientific literature can vary considerably among institutions and healthcare systems,” said Yuki Arita, MD, PhD, professor of the Graduate School of Medical and Dental Sciences at the Institute of Science Tokyo and assistant editor of Radiology Advances. “Open access removes an important barrier by allowing radiologists, researchers, trainees and other healthcare professionals to engage with new findings regardless of their institution’s subscription resources.”
The international exchange of knowledge can also reveal whether an imaging technology holds up across differences in disease prevalence, patient characteristics, scanner availability and clinical practice.
“Evaluating research across these diverse settings can lead to more robust evidence, more generalizable imaging standards and technologies, and more equitable implementation,” Dr. Arita said. “Ultimately, this process strengthens imaging science by ensuring that advances are not only technically innovative, but also clinically meaningful and applicable to patients in a wide range of healthcare settings.”
Even as it expands access to research, open access does not erase every inequity. Publication costs often shift from readers and libraries to researchers and their institutions through article processing charges, creating new barriers for authors with fewer resources.
The growth of open access has also highlighted the need for authors to distinguish reputable publications from journals that charge fees without providing meaningful peer review.
RSNA journals, including Radiology Advances, follow standards set by the Committee on Publication Ethics and the International Committee of Medical Journal Editors, designed to protect researchers seeking reputable venues and readers seeking trustworthy evidence.
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