Advanced imaging technologies such as CT and MRI have transformed diagnostic medicine, yet their economic and operational demands remain substantial. A hospital-grade CT scanner typically costs $1–$2 million, with annual maintenance contracts often exceeding $100,000. MRI systems require even greater investment—usually $1.5–$3 million upfront—along with cryogenic cooling, magnetic shielding, and more complex installation and upkeep. Additional expenses arise from tube replacements, system downtime, and the need for trained technical staff. While large academic hospitals can absorb these costs, small rural facilities often cannot. Many lack on-site radiologists, full-time technologists, dedicated maintenance engineers, or sufficient patient volume to justify such systems. As a result, numerous rural hospitals struggle to maintain CT and MRI services, forcing patients to travel long distances to regional centers, leading to delays in diagnosis and added risk. For older adults, especially Medicare beneficiaries, the burden is heightened by substantial transportation expenses and logistical challenges. These barriers contribute to significant gaps in diagnostic access.

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In elderly and palliative care, the clinical need often differs from that of conventional hospital practice. At advanced age or near the end of life, most decisions do not require high-precision imaging; instead, clinicians need clear answers to whether large effusions, bowel obstructions, urinary retention, or fractures are present—conditions that directly influence comfort and immediate management. Transporting frail or terminally ill patients to distant facilities can cause considerable harm, including pain, fatigue, delirium, infection, and psychological distress. For many, the burden of travel outweighs the value of obtaining high-fidelity images. These realities underscore the importance of bringing imaging closer to the patient, ideally to the bedside, through technologies that are affordable, easier to maintain, and operable by non-specialists.

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Recent developments in low-cost imaging offer practical alternatives. The evolution of dental CBCT demonstrates that high-cost components of conventional CT systems can be replaced by low-speed gantries, compact designs, minimal shielding, and low-dose protocols that simplify maintenance. Adapted into whole-body or torso CBCT configurations, such systems could detect major abnormalities at a fraction of the cost of traditional scanners. Low-field MRI provides another opportunity. With advances in AI-driven reconstruction, MRI units operating at 0.05–0.2 Tesla can now produce clinically meaningful images without cryogenic cooling or heavy infrastructure, making installation feasible in smaller facilities previously unable to support MRI. These approaches reduce operational complexity and broaden access by enabling general clinicians—not only specialists—to perform essential imaging.

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Artificial intelligence plays a central role in enabling this shift toward simplified imaging. Automated acquisition guidance can help non-experts position scanners, adjust parameters, detect inadequate contact or motion, and receive real-time feedback, expanding the number of healthcare workers capable of acquiring diagnostic-quality data. AI-based reconstruction and enhancement methods can correct motion, remove scatter, compensate for missing angles, and improve resolution, allowing lower-cost hardware to produce clinically useful images. AI-generated summaries and triage reports can highlight relevant abnormalities, provide streamlined visualizations, flag urgent findings, and track changes over time. These tools help reduce interpretation burdens for clinicians in resource-limited settings and integrate naturally with remote tele-radiology when needed.

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Together, these developments point toward a practical reconfiguration of diagnostic imaging for elderly and palliative populations. By lowering costs, simplifying maintenance, reducing dependence on specialized personnel, and incorporating AI-driven assistance, imaging can move from centralized hospitals to the communities—and even the bedside—where it is most needed.