Radiology strongly impacts patient care. However, radiologists' potential to promote high-value care has long been underappreciated, partly related to difficulties in establishing their role in driving patient-oriented outcomes (e.g., reduced morbidity and mortality; improved quality of life). Recognizing this gap, the American College of Radiology convened the Relevance and Impact Committee to develop a framework for measuring radiologists' impact. The committee proposed two foundational concepts: diagnostic imaging provenance (the lineage underlying a diagnosis being established) and relevance (the manner in which a diagnosis relates to upstream reasons for examinations and downstream decision-making). The committee applied these concepts to develop the medical imaging life cycle framework as a patient and practitioner centric feedback loop whereby each examination serves as a potential care inflection point and pertinent positive and negative findings alter patient trajectories. Advances in data science, including large-scale EHR-driven analyses and generative artificial intelligence, now aid tracking of such relationships, helping to operationalize a longstanding vision of linking imaging to outcomes. This Perspective explores these core concepts and terminology underlying measurement of radiology's impact and seeks to provide a roadmap for their implementation within modern healthcare systems. Such application will promote radiologists' recognition as proximal agents of clinically impactful high-value care.