Sustainability in Radiology: Position Paper and Call to Action from ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA.

The urgency for climate action is recognized by international government and healthcare organizations, including the United Nations (UN) and World Health Organization (WHO). Climate change, biodiversity loss, and pollution negatively impact all life on earth. All populations are impacted but not equally; the most vulnerable are at highest risk, an inequity further exacerbated by differences in access to healthcare globally. The delivery of healthcare exacerbates the planetary health crisis through greenhouse gas emissions, largely due to combustion of fossil fuels for medical equipment production and operation, creation of medical and non-medical waste, and contamination of water supplies. As representatives of radiology societies from across the globe who work closely with industry, and both governmental and non-governmental leaders in multiple capacities, we advocate together for urgent, impactful, and measurable changes to the way we deliver care by further engaging our members, policymakers, industry partners, and our patients. Simultaneous challenges including global health disparities, resource allocation, and access to care must inform these efforts. Climate literacy should be increasingly added to radiology training programs. More research is required to understand and measure the environmental impact of radiological services and inform mitigation, adaptation, and monitoring efforts. Deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy utilization, and circular economy. Many solutions have been proposed and are already available, but we must understand and address barriers to implementation of current and future sustainable innovations. Finally, there is a compelling need to partner with patients to ensure that trust in the excellence of clinical care is maintained during the transition to sustainable radiology. By fostering a culture of global cooperation and rapid sharing of solutions amongst the broader imaging community, we can transform radiological practice to mitigate its environmental impact, adapt and develop resilience to current and future climate and environmental threats, and simultaneously improve access to care. This article is simultaneously published in the (DOI 10.1177/08465371241321390), (DOI 10.1007/s00330-025-11413-7), (DOI 10.1111/1754-9485.13842), (DOI 10.1016/j.jacr.2025.02.009), (DOI 10.3348/kjr.2025.0125) and (DOI 10.1148/radiol.250325). The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either DOI can be used when citing this article. Climate Change, Sustainability, Resource Allocation, Radiology, Health Services Accessibility Published under a CC BY 4.0 license. © The Author(s) 2025. Editor's Note: The RSNA Board of Directors has endorsed this article.