Environmental Sustainability in Radiology: A Global Bibliometric Analysis of Growth, Structure, and Emerging Research Priorities

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PURPOSE: To evaluate the growth, structure, and evidentiary maturity of research related to environmental sustainability in radiology using bibliometric analysis and science mapping. METHODS: A comprehensive bibliometric analysis was conducted to identify publications related to environmental sustainability in radiology. Performance metrics included temporal trends, publication types, journals, countries, and citation analysis. Science mapping techniques included co-authorship networks and thematic classification. Publications were categorized into non-mutually exclusive domains of mitigation, adaptation, and resilience. RESULTS: A total of 535 publications were included, with a marked increase in annual output after 2019; 54% of all publications were published in 2024 to 2025 alone. Publications had a median of 7 citations (IQR 2-24), with 2720 unique authors and a median of 6 authors per publication (IQR 3-10). Overall, 166 publications (31%) involved international collaboration. The field demonstrated substantial heterogeneity in evidentiary maturity: mitigation accounted for the largest proportion of publications (60%) but a minority were original research (39%), whereas adaptation (41%) was primarily composed of original research (83%) with higher citation impact. Resilience was minimally represented (2%). Publications were distributed across 252 journals, with a core group of journals and collaborative author networks indicating emerging structural consolidation. CONCLUSION: Environmental sustainability in radiology is a rapidly expanding and increasingly collaborative field. While adaptation research is embedded within broader environmental health literature, mitigation is transitioning toward data-driven implementation, and resilience remains a critical gap. These findings highlight the need to advance implementation-focused research, develop standardized metrics, and prioritize system resilience to support sustainable radiology practice.

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