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Figure 2 (A) The current process of imaging development requires only demonstration of technical capability or test performance for reimbursement and subsequent clinical adoption, without a need for demonstration of clinical utility. Further, there are few intermediate steps designed to assess the impact of such use and few guidelines directed at ensuring appropriate care. Finally, it is linear, with little feedback from clinical experience onto subsequent technology development. (B) An ideal cycle of imaging development would incorporate all of these steps into a continuous creation of evidence and incorporation into clinical care as well as the development of new imaging technology.