1.Sustainability in Radiology: Position Paper and Call to Action From ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA
Andrea G. ROCKALL ; Bibb ALLEN ; Maura J. BROWN ; Tarek EL-DIASTY ; Jan FLETCHER ; Rachel F. GERSON ; Stacy GOERGEN ; Amanda P. MARRERO GONZÁLEZ ; Thomas M. GRIST ; Kate HANNEMAN ; Christopher P. HESS ; Evelyn Lai MING HO ; Dina H. SALAMA ; Julia SCHOEN ; Sarah SHEARD
Korean Journal of Radiology 2025;26(4):294-303
The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (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 programmes. 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.
2.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
3.Sustainability in Radiology: Position Paper and Call to Action From ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA
Andrea G. ROCKALL ; Bibb ALLEN ; Maura J. BROWN ; Tarek EL-DIASTY ; Jan FLETCHER ; Rachel F. GERSON ; Stacy GOERGEN ; Amanda P. MARRERO GONZÁLEZ ; Thomas M. GRIST ; Kate HANNEMAN ; Christopher P. HESS ; Evelyn Lai MING HO ; Dina H. SALAMA ; Julia SCHOEN ; Sarah SHEARD
Korean Journal of Radiology 2025;26(4):294-303
The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (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 programmes. 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.
4.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
5.Sustainability in Radiology: Position Paper and Call to Action From ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA
Andrea G. ROCKALL ; Bibb ALLEN ; Maura J. BROWN ; Tarek EL-DIASTY ; Jan FLETCHER ; Rachel F. GERSON ; Stacy GOERGEN ; Amanda P. MARRERO GONZÁLEZ ; Thomas M. GRIST ; Kate HANNEMAN ; Christopher P. HESS ; Evelyn Lai MING HO ; Dina H. SALAMA ; Julia SCHOEN ; Sarah SHEARD
Korean Journal of Radiology 2025;26(4):294-303
The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (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 programmes. 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.
6.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
7.Sustainability in Radiology: Position Paper and Call to Action From ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA
Andrea G. ROCKALL ; Bibb ALLEN ; Maura J. BROWN ; Tarek EL-DIASTY ; Jan FLETCHER ; Rachel F. GERSON ; Stacy GOERGEN ; Amanda P. MARRERO GONZÁLEZ ; Thomas M. GRIST ; Kate HANNEMAN ; Christopher P. HESS ; Evelyn Lai MING HO ; Dina H. SALAMA ; Julia SCHOEN ; Sarah SHEARD
Korean Journal of Radiology 2025;26(4):294-303
The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (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 programmes. 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.
8.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
9.Sustainability in Radiology: Position Paper and Call to Action From ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA
Andrea G. ROCKALL ; Bibb ALLEN ; Maura J. BROWN ; Tarek EL-DIASTY ; Jan FLETCHER ; Rachel F. GERSON ; Stacy GOERGEN ; Amanda P. MARRERO GONZÁLEZ ; Thomas M. GRIST ; Kate HANNEMAN ; Christopher P. HESS ; Evelyn Lai MING HO ; Dina H. SALAMA ; Julia SCHOEN ; Sarah SHEARD
Korean Journal of Radiology 2025;26(4):294-303
The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (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 programmes. 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.
10.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

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