Radiology Decision Intelligence

Smarter Imaging Orders.
AI-Assisted Reports.

Evidence-based utilization review and AI-drafted radiology reports — reviewed and signed by board-certified radiologists. Built for the future of diagnostic medicine.

80% Volume Coverage
CT, CXR, Bone X-Ray
<60s Draft Report
AI-Generated
ACR Guideline-Based
Decision Support
AI ANALYSIS ACTIVE
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CT CHEST / ABDOMEN
Lungs:No acute cardiopulmonary process
Heart:Normal in size and contour
Mediastinum:Within normal limits
Impression:

Built by Radiologists,
For the Healthcare System

ApertureAI was founded by a board-certified radiologist and Kellogg MBA with deep experience in FDA-cleared medical AI devices. We know the reporting stack, the regulatory landscape, and what clinicians actually need.

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Clinical Accuracy First

Every decision pathway is grounded in ACR Appropriateness Criteria and clinical evidence. No black boxes — radiologists review every AI-generated draft before it reaches the record.

Utilization Review Engine

Our decision-tree engine guides ordering physicians through evidence-based imaging selection — reducing unnecessary studies, cutting costs, and improving patient outcomes.

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AI Draft Reports

AI-generated draft reports for the modalities covering ~80% of clinical volume: CT Head, CT Abd/Pel, CTA Chest, CXR, and Bone X-Rays. Radiologist-signed. Always.

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Hospital-Ready

Designed to integrate with existing PACS and RIS infrastructure. Compatible with PowerScribe, Fluency, and SynthOS reporting environments. Proven hospital relationships.

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Canada Health Partnership

Actively developing utilization review tools for Canada Health's diagnostic imaging ordering system — reducing wait times and improving resource allocation nationally.

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Regulatory Compliant

Built with FDA Class I/II device experience and HIPAA/PIPEDA compliance in mind. We know the regulatory path — and we've walked it before.

DR

Dr. Aldo Ruffolo, DO, MBA

Founder & Chief Radiologist

Triple board-certified radiologist with an MBA from Kellogg School of Management (Northwestern). Former CEO of a medical AI company with an FDA-cleared Class I device. Has trained thousands of radiology residents. Holds approved privileges at multiple hospital systems — the deployment network is already built.

3x Board Certified Kellogg MBA FDA Device Exp. Former Med-AI CEO

See It in Action

Two tools in one: evidence-based imaging order review and AI-generated report drafting.

Answer clinical questions below to receive an evidence-based imaging recommendation. Powered by ACR Appropriateness Criteria.

Step 1

Chief Complaint / Clinical Question

Step 2

Headache Characterization

Step 3

Urgency Assessment

Step 3

Red Flag Screening

Step 2

Chest Presentation

Step 2

Abdominal Presentation

Step 2

MSK Presentation

Step 2

Trauma Severity

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RECOMMENDED: CT Head Without Contrast

URGENT — Order Immediately

Clinical Rationale

Acute high-acuity headache presentations (thunderclap, focal neuro deficit, meningismus <72h, head trauma with LOC) require immediate non-contrast CT Head to exclude hemorrhagic stroke, subarachnoid hemorrhage, or mass effect.

ACR Appropriateness Rating

9/9 — Usually Appropriate

Order Specifics

  • ✅ CT Head WITHOUT contrast (initial evaluation)
  • ✅ STAT priority — read within 30 minutes
  • ⚠️ If subarachnoid hemorrhage suspected and CT negative → LP or CT Angiogram
  • ⚠️ Consider MRI Brain if CT negative and clinical suspicion persists

CPT Code

70450 — CT Head/Brain Without Contrast
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RECOMMENDED: MRI Brain With & Without Contrast

ROUTINE — Schedule within 1-2 weeks

Clinical Rationale

Subacute or evolving neurological symptoms with clinical concern benefit from MRI for superior soft tissue resolution, evaluation of white matter pathology, and mass lesion characterization.

ACR Appropriateness Rating

8/9 — Usually Appropriate

Order Specifics

  • ✅ MRI Brain With AND Without Contrast
  • ✅ Include DWI sequences (stroke protocol)
  • ⚠️ Screen for contraindications: implants, claustrophobia, renal function (gadolinium)
  • ℹ️ Alternative: CT Head if MRI contraindicated

CPT Code

70553 — MRI Brain With & Without Contrast

IMAGING NOT INDICATED

Low Clinical Yield

Clinical Rationale

Chronic stable headaches without red flags (thunderclap onset, new focal deficit, fever, papilledema, immunocompromised, age >50 with new pattern, trauma) have very low yield for imaging. Clinical management and reassurance are appropriate first-line.

ACR Appropriateness Rating

2/9 — Usually Not Appropriate

Recommended Action

  • ✅ Clinical management — reassurance + symptom diary
  • ✅ Trial of appropriate headache medications
  • ⚠️ Return precautions: any red flags → immediate re-evaluation
  • ℹ️ Neurology referral if refractory or escalating pattern
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RECOMMENDED: CTA Chest (PE/Aorta Protocol)

URGENT — Order Immediately

Clinical Rationale

High clinical suspicion for PE (Wells ≥2 + positive D-dimer) or aortic dissection requires CTA Chest for definitive vascular evaluation. Time-sensitive — delay increases mortality.

ACR Appropriateness Rating

9/9 — Usually Appropriate

Order Specifics

  • ✅ CTA Chest — PE Protocol (or Aorta Protocol if dissection suspected)
  • ✅ STAT — read within 30–60 minutes
  • ⚠️ Confirm renal function before contrast (GFR >30)
  • ⚠️ Pregnancy — consult before ordering; V/Q scan alternative

CPT Code

71275 — CTA Chest With Contrast (PE Protocol)
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RECOMMENDED: Chest X-Ray (PA & Lateral)

ROUTINE / SEMI-URGENT

Clinical Rationale

Chest radiograph is the appropriate first-line study for suspected pneumonia and general cardiopulmonary evaluation. Low cost, low radiation, widely available.

ACR Appropriateness Rating

8/9 — Usually Appropriate

Order Specifics

  • ✅ CXR PA and Lateral views
  • ℹ️ If high suspicion for pneumonia despite negative CXR → consider CT Chest
  • ℹ️ Portable AP if patient unable to stand

CPT Code

71046 — Chest X-Ray PA & Lateral
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RECOMMENDED: CT Abdomen & Pelvis With Contrast

URGENT / SEMI-URGENT

Clinical Rationale

CT Abdomen/Pelvis with IV contrast is the workhorse for acute abdominal evaluation, appendicitis workup, and renal colic (consider without contrast for stones).

ACR Appropriateness Rating

8/9 — Usually Appropriate

Order Specifics

  • ✅ CT Abdomen & Pelvis WITH IV contrast (general acute abdomen / appendicitis)
  • ✅ CT Abdomen & Pelvis WITHOUT contrast (renal colic / stone protocol)
  • ⚠️ Confirm renal function and allergy history
  • ℹ️ Consider ultrasound first in pregnant patients or children

CPT Codes

74177 — CT Abd/Pel With Contrast
74178 — CT Abd/Pel With & Without Contrast
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RECOMMENDED: Ultrasound Abdomen (RUQ)

ROUTINE / SEMI-URGENT

Clinical Rationale

RUQ ultrasound is first-line for suspected biliary pathology (cholelithiasis, cholecystitis, biliary dilation). No radiation, no contrast, highly sensitive for gallbladder disease.

ACR Appropriateness Rating

9/9 — Usually Appropriate

Order Specifics

  • ✅ US Abdomen — RUQ / Gallbladder
  • ✅ NPO 4–6 hours for optimal gallbladder visualization
  • ℹ️ If US inconclusive → MRCP or CT Abdomen/Pelvis

CPT Code

76700 — US Abdomen Complete
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RECOMMENDED: Plain Radiograph (X-Ray)

ROUTINE FIRST-LINE

Clinical Rationale

Plain radiography is the appropriate first-line study for suspected fracture, arthritis evaluation, and acute MSK trauma. Low cost, low radiation, immediately actionable.

ACR Appropriateness Rating

8/9 — Usually Appropriate

Order Specifics

  • ✅ At minimum 2 views of affected site (AP + Lateral)
  • ℹ️ If fracture occult on X-ray → MRI for occult fracture detection
  • ℹ️ Comparison views of contralateral side if pediatric patient

CPT Codes (examples)

73030 — Shoulder 2 views | 73562 — Knee 3 views | 73600 — Ankle 2 views
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RECOMMENDED: MRI of Affected Joint/Region

ROUTINE

Clinical Rationale

MRI is superior for soft tissue evaluation (ligaments, tendons, cartilage, menisci). Should be preceded by plain X-ray unless acute soft tissue injury with specific surgical planning need.

ACR Appropriateness Rating

8/9 — Usually Appropriate

Order Specifics

  • ✅ MRI of affected joint WITHOUT contrast (most MSK indications)
  • ✅ MRI WITH contrast if infection, tumor, or synovitis suspected
  • ⚠️ Prior X-ray recommended first (ACR guideline)
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RECOMMENDED: MRI (preferred) or Bone Scan

SEMI-URGENT

Clinical Rationale

MRI is now the preferred modality for osteomyelitis evaluation (superior sensitivity/specificity). Bone scan (Tc-99m) is an alternative when MRI is contraindicated.

ACR Appropriateness Rating

8/9 — MRI Usually Appropriate

Order Specifics

  • ✅ MRI of affected area With Contrast (preferred for osteomyelitis)
  • ℹ️ Three-phase bone scan if MRI contraindicated
  • ⚠️ Labs: WBC, ESR, CRP, blood cultures before imaging
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RECOMMENDED: Trauma CT Protocol

URGENT — STAT

Clinical Rationale

Major/polytrauma requires rapid whole-body assessment. Pan-scan protocol (CT Head, CT C-Spine, CT Chest/Abd/Pel with contrast) provides comprehensive evaluation in minutes.

ACR Appropriateness Rating

9/9 — Usually Appropriate (polytrauma)

Order Specifics

  • ✅ CT Head WITHOUT contrast
  • ✅ CT C-Spine WITHOUT contrast
  • ✅ CT Chest/Abdomen/Pelvis WITH contrast (trauma protocol)
  • ✅ STAT — coordinate with trauma team

CPT Codes

70450 + 72125 + 71250 + 74177

Select a modality and clinical context below. ApertureAI will generate a structured draft report — ready for radiologist review and signature.

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Select a modality and click Generate to see an AI-drafted report

⚠️ Demo Only: Reports generated here are illustrative templates for demonstration purposes. In production, AI analysis is based on actual imaging data and must be reviewed, edited, and signed by a licensed radiologist before any clinical use.

Ready to Transform Your
Radiology Workflow?

Whether you're a hospital system, imaging center, or health authority — let's talk about what ApertureAI can do for you.

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Partnerships

Hospital systems, imaging centers, health authorities, and EHR vendors welcome.

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Canada Health

Currently developing utilization review tools for Canadian diagnostic imaging ordering.

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Pilot Program

Limited pilot slots available. Radiologist-supervised deployment at your facility.

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