Clinical Imaging Platform Engineer

a2z Radiology AI

Clinical imaging platform engineer building radiologist annotation and visualization tools for FDA-cleared clinical AI. Improving DICOM viewers, 3D segmentation workflows, model outputs, and HIPAA-compliant AWS infrastructure.

Posted 8/10/2026full-timeBoston • Massachusetts • 🇺🇸 United StatesMid-LevelSenior💰 $140,000 - $180,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in developing clinical imaging software with a focus on user-centered design, annotation systems, and compliance with healthcare regulations. Proficient in utilizing advanced technologies such as FastAPI, AWS, and DICOM for efficient data handling and processing.

Highest-signal resume keywords

Clinical Imaging Software DevelopmentAnnotation System DesignFastAPI Development on AWSDICOM and Cornerstone3D ExperienceSafe-by-Default Engineering

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

ReactTypeScriptVTK.jsFastAPIDICOMHTJ2KNIfTIRLEGeometric Mask DiagnosisAnnotation Tooling

Soft Skills

User ObservationCollaboration with RadiologistsChallenging Software Decisions

Tools & Technologies

AWSTerraformViteJotaiTanStack QueryTailwindPlaywrightPytest

Certifications & Qualifications

ISO 13485IEC 62304HIPAA Compliance

Industry Keywords

Medical ImagingAnnotation EvaluationInter-Rater AgreementStreaming CodecRegulated Software

Tech Stack

Tools & technologies

AWSJavaScriptPythonReactTerraformTypeScript

About the role

Key responsibilities & impact

Own the clinical imaging viewer built on Cornerstone3D and VTK.js
Build a unified volume-rendering path with stack-rendering fallback
Generate on-demand multiplanar reformats in any plane and label them clearly
Implement progressive loading from the first approximately 10% of each HTJ2K codestream
Ensure radiological left/right correctness, rulers under gantry tilt, MONOCHROME1 inversion, and signed-pixel codec compatibility
Build and improve the 3D annotation system, including mask storage, click-to-segment across three planes, region growing, FWHM thresholding, and multi-seed refinement
Develop annotation evaluation infrastructure including case-pool ledgers, annotator phase state machines, ground-truth and peer-overlap batches, agreement scorecards, and cross-series resampling through NIfTI affines
Design per-lesion-category annotation schemas with gating by view, phase, and slice, including conditionally required fields, in collaboration with radiologists
Build versioned sparse-RLE mask contracts keyed by SOP Instance UID
Implement geometry mapping from model grids through image position, direction cosines, and pixel spacing into world-space contours
Develop the FastAPI platform on AWS
Enforce per-study authorization on every read and isolate customer cohorts
Implement access-trail auditing meeting HIPAA §164.312(b) for study-data reads
Improve annotation interfaces by observing radiologist workflows and increasing annotation throughput and model quality
Collaborate with radiologists on clinical annotation decisions

Requirements

What you’ll need

Experience building software used for hours a day and improving it by observing users
Instinct to use metrics to assess annotation quality
Comfort with coordinate systems and diagnosing geometric mask errors
Safe-by-default engineering when handling patient data
Ability to challenge radiologists on software decisions while deferring to them on medical decisions
Helpful but not required: strong React and TypeScript with real performance work
Helpful but not required: backend API and asynchronous experience
Helpful but not required: medical imaging experience with DICOM, Cornerstone3D, OHIF, or PACS
Helpful but not required: annotation tooling experience
Helpful but not required: AWS and Terraform
Helpful but not required: segmentation or computer vision
Helpful but not required: inter-rater agreement and measurement design
Helpful but not required: regulated software experience with ISO 13485, IEC 62304, or HIPAA
Helpful but not required: codec or streaming work such as HTJ2K
Technical stack includes React, TypeScript, Vite, Cornerstone3D, VTK.js, Jotai, TanStack Query, Tailwind, Playwright, Python, FastAPI, pytest, AWS, Terraform, DICOM, DICOMweb, HTJ2K, NIfTI, and RLE
International candidates work from their own country; no visa is needed
Application requires a CV and GitHub

Benefits

Comp & perks

Approximately 10% discretionary bonus
Equity may be offered to top candidates
International offers are cash-only, with no equity
Remote work from the candidate's own country for international candidates
Same repositories, data, and review authority as anyone on the team for international engineers
Written and asynchronous reviews
Contractor or employee engagement through an employer of record, depending on country