IEEE Transactions on Medical Imaging 'Under Review': Status Meanings

Before the paper reaches external reviewers, an IEEE TMI Associate Editor evaluates whether the methodology significance and page-limit compliance warrant IEEE TMI's editorial slots. About 40 to 50 percent of submissions are desk-rejected at this stage.

A desk rejection most often means the Associate Editor concluded that the work is pure clinical application without methodology contribution (TMI publishes methodology, not pure applications), exceeds the strict 10-page initial-submission limit (including references), applies existing deep-learning architectures to new medical-imaging tasks without introducing methodological advances, reports results on bespoke datasets without standardized comparison, or would fit better at a sister IEEE journal (IEEE Journal of Biomedical and Health Informatics, IEEE Transactions on Biomedical Engineering, IEEE Transactions on Medical Robotics and Bionics).

The IEEE TMI editorial office confirms files are complete: manuscript with figures embedded within the strict 10-page initial-submission limit (including references), Supporting Information with benchmark results on standardized medical imaging datasets, IEEE template formatting, cover letter directed to the editor naming the methodology contribution, conflict-of-interest declarations, ethics-statement documentation, IRB approvals where applicable, and data-availability statement.

The handling Associate Editor reads the paper and evaluates medical imaging methodology significance, comparison to state-of-the-art rigor, standardized benchmark coverage, page-limit compliance, and TMI subspecialty routing.

In parallel with the Associate Editor's primary read, ambiguous-fit papers are discussed across the IEEE Computer Society/EMBS editorial team where peer Associate Editors weigh in on whether the paper would fit better at IEEE TMI or at sister IEEE biomedical engineering journals. This editorial consultation runs alongside the desk-screen and adds 3 to 5 days to the timeline that is invisible to the author in the portal.

IEEE TMI Associate Editors typically invite 2 to 3 reviewers per IEEE Computer Society norm. Reviewer recruitment typically takes 7 to 14 days.

Once 2 to 3 reviewers agree to review, the typical IEEE TMI peer-review cycle lasts 4 to 8 weeks per reviewer per IEEE guidance. One reported first review round took 6.1 weeks. Reviewers are asked to evaluate methodology significance, comparison to state-of-the-art rigor, benchmark coverage adequacy, and reproducibility.

After reports return, the Associate Editor synthesizes them. IEEE journals lack mechanisms to enforce reviewer deadlines, making it difficult to predict the duration of the peer review process. Total submission-to-acceptance commonly runs 6 to 12 months for successful papers, including revision rounds.

• Rejection within 1 to 3 days: Page-limit non-compliance (exceeds strict 10-page initial submission including references) or administrative issue.

• Rejection within 7 to 21 days: Associate Editor desk rejection per the 40 to 50 percent figure.

• Still Under Review after 3 weeks: Strong signal. Paper passed the Associate Editor desk screen.

• Still Under Review after 16 weeks: Reviewer-recruitment or reviewer-report delay. A polite inquiry via the ScholarOne portal is appropriate.

• Status changes to "Decision Pending": Reports are in; expect a decision within 1 to 2 weeks after Associate Editor analysis.

This is the most common anxiety we hear from IEEE TMI authors during the active editorial window. The honest answer: no, 8 weeks at Under Review puts you in the normal middle of IEEE TMI's 8 to 16 week peer-review distribution for the multi-reviewer model. Reports may still be arriving with the Associate Editor preparing for editorial synthesis.

Most reviewer-driven delays come from the lack of mechanism to enforce reviewer deadlines (IEEE journals typically request 3 to 4 weeks but cannot enforce) rather than slow reviews. If the portal still says Under Review at the 16-week mark, the most likely explanation is that one or more of the assigned reviewers asked for an extension and the Associate Editor granted it.

This is normal practice at IEEE TMI.

What you should NOT do during the 8-to-16-week window is email the editorial office. IEEE TMI Associate Editors are working academic medical imaging researchers managing 60+ active papers per year; an inquiry at 8 weeks adds friction without accelerating the timeline.

If your IEEE TMI paper is rejected after review, the natural cascade depends on what the reviewers and Associate Editor cited:

IEEE Journal of Biomedical and Health Informatics is the natural IEEE EMBS cascade for biomedical informatics papers.

IEEE Transactions on Biomedical Engineering is the IEEE EMBS cascade for biomedical engineering papers.

IEEE Transactions on Medical Robotics and Bionics is the IEEE EMBS cascade for medical robotics.

IEEE Transactions on Pattern Analysis and Machine Intelligence (TPAMI) is the IEEE Computer Society cascade for pattern analysis methodology. TPAMI uses ScholarOne at ScholarOne submission portal; editorial contact tpami@computer.ieee.org.

Medical Image Analysis (Elsevier) is the external Elsevier medical imaging cascade. Medical Image Analysis uses Editorial Manager at Editorial Manager submission portal; editorial contact mia@elsevier.com.

MICCAI conference proceedings (Springer) is the external Springer MICCAI conference cascade.

IEEE asks reviewers at IEEE TMI to evaluate four things specifically. The table below maps each to actionable preparation.

Across IEEE TMI-targeted manuscripts, and across Manusights review data from 50+ medical-imaging, computer-vision, and biomedical-engineering manuscripts, three named patterns generate the most consistent reviewer concerns and the most common reasons papers miss the editorial bar or fail the desk screen.

Page-limit non-compliance flagged at administrative check. When the manuscript exceeds the strict 10-page initial-submission limit including references, IEEE TMI returns the paper at the administrative check. A typical CS/EE-style 12-page paper with a long related-work section gets returned before an Associate Editor can evaluate the science. The strongest manuscripts use the introduction and first method figure to make the medical-imaging contribution visible without spending pages on generic deep-learning background.

Pure-application framing without methodology contribution flagged at Associate Editor desk screen. When the work applies existing deep-learning architectures to new medical-imaging tasks without introducing methodological advances, IEEE TMI rejection is common. The strongest manuscripts state the reusable method in the title, abstract, contribution paragraph, and experiments, then connect the method to medical-imaging-specific constraints such as scarce labels, domain shift, registration uncertainty, modality fusion, or scanner/site variation.

Bespoke-dataset framing flagged as reviewer concerns. When the work reports results on bespoke datasets without standardized comparison, reviewers consistently flag concerns. The strongest IEEE TMI submissions include public or multi-site benchmarks, recent baselines, ablation studies, calibration or error analysis, code/data availability language, and a clear explanation of what cannot be shared because of patient privacy or institutional constraints.

We also check whether the cover letter and manuscript tell the same methodology story, because IEEE TMI reviewers are quick to separate a reusable imaging method from a private clinical deployment.

Source limitation: this guidance combines official guidance, public status and timing signals, and anonymized Manusights pre-submission review patterns; it does not use private IEEE editorial records. Compared with official guidance, the useful reader-facing value is translating the status into page-limit, contribution-statement, benchmark, reproducibility, and IEEE routing checks authors can act on while waiting.

This page was created from IEEE's public IEEE TMI Information for Authors at ieeexplore.ieee.org, IEEE Computer Society/EMBS editorial documentation (strict 10-page initial-submission limit including references, 6.1-week reported first review round, 3 to 4 week reviewer target, methodology-not-applications focus, standardized benchmark coverage expectation), and Manusights pre-submission review experience with IEEE TMI-targeted manuscripts.

For the IEEE medical imaging landscape beyond IEEE TMI, start with the IEEE Transactions on Medical Imaging journal overview, the IEEE TMI submission guide, the IEEE TPAMI status guide, and the International Journal of Computer Vision status guide.

Then compare IEEE Journal of Biomedical and Health Informatics (biomedical informatics), IEEE Transactions on Biomedical Engineering (biomedical engineering), IEEE Transactions on Medical Robotics and Bionics (medical robotics), IEEE Transactions on Pattern Analysis and Machine Intelligence (pattern analysis), and external medical imaging alternatives (Medical Image Analysis from Elsevier, MICCAI conference proceedings from Springer).

The choice across these titles depends on whether the central contribution is top medical imaging methodology (IEEE TMI), biomedical informatics (IEEE J Biomedical and Health Informatics), biomedical engineering (IEEE Transactions on Biomedical Engineering), medical robotics (IEEE Transactions on Medical Robotics and Bionics), pattern analysis (IEEE TPAMI), Elsevier medical image analysis (Medical Image Analysis), or MICCAI conference (MICCAI proceedings).

Reviewers at IEEE TMI typically draw from 2 to 3 medical imaging subspecialty experts under the IEEE double-blind model. Editors screen and triage manuscripts before any external reviewer sees them, and preparing a response template that addresses methodology significance, benchmark coverage, and reproducibility accelerates revision rounds substantially.

For a pre-upload check of your manuscript against the IEEE TMI methodology-plus-benchmark-plus-page-limit bar before submission, our IEEE Transactions on Medical Imaging pre-submission diagnostic flags the page-limit and methodology weaknesses most likely to surface in the Associate Editor desk screen.