Pearl vs Subtle Medical
Dentists and dental groups buy Pearl while imaging departments buy Subtle Medical, so each product answers to a different buyer. Pearl's Second Opinion marks caries, bone loss and restorations on dental bitewing, periapical and panoramic films, and its FAQ names DEXIS, Carestream, Romexis, Open Dental and Eaglesoft among its integrations. Subtle Medical says its software is vendor-neutral and offers SubtleHD for MR, PET and CT.
The clearance records read differently. Subtle's About page and openFDA both show eleven, the latest SubtleHD-CT on May 15, 2026. Pearl's home page says 26+ clearances while openFDA lists eight Second Opinion decisions, the latest the panoramic tool on November 14, 2025.
An imaging department weighing SubtleHD(MR) has the vendor's claim of up to 80% faster MRI sequences. A dental group weighing Second Opinion has a 2026 Caries Research comparison of five commercial systems on secondary caries in bitewings, which reported sensitivity from 0.327 to 0.487 across the five systems, Second Opinion included.
Radiology · Reviewed November 2, 2026
Pearl
by Pearl Inc. · founded 2019
FDA-cleared dental x-ray AI (Second Opinion) that marks caries, bone loss and restorations, for dentists and DSOs.
Subtle Medical
by Subtle Medical
Vendor-neutral deep-learning software that improves MR, PET and CT image quality on faster or lower-dose protocols.
When to pick each one
Pearl
- Second Opinion for bitewing, periapical and panoramic films
- Names Open Dental, Eaglesoft and DEXIS integrations
- Eight Second Opinion decisions on openFDA
Subtle Medical
- SubtleHD lines for MR, PET and CT
- Eleven FDA clearances, latest May 15, 2026
Score
Each row shows points earned of points available under the published rubric.
Pearl
33of 100
Subtle Medical
37of 100
| Dimension | Pearl | Subtle Medical | Difference |
|---|---|---|---|
| FDA clearance | 18 / 18 | 18 / 18 | 0 |
| HIPAA / SOC2 / BAA | 0 / 10 | 0 / 10 | 0 |
| EHR integrations (count) | 0 / 4.2 | 0 / 4.2 | 0 |
| Top-3 EHR coverage (Epic / Oracle / Athena) | 0 / 2.4 | 0 / 2.4 | 0 |
| Peer-reviewed papers | 0 / 18.2 | 7.3 / 18.2 | -7.3 |
| RCT / meta-analysis / systematic review | 0 / 7.8 | 0 / 7.8 | 0 |
| Funding & adoption signal | 3 / 12 | 3 / 12 | 0 |
| Pricing transparency | 2.5 / 5 | 2.5 / 5 | 0 |
| Years in market | 4.2 / 6 | 0 / 6 | +4.2 |
Scroll horizontally to see every column.
Pricing
Pearl
| Tier | Monthly | Annual | Notes |
|---|---|---|---|
| Enterprise | n/a | n/a | No public price. |
Subtle Medical
| Tier | Monthly | Annual | Notes |
|---|---|---|---|
| Enterprise | n/a | n/a | No public price. Billing period, trial and refund not stated. |
Evidence
Pearl
FDA decisions
K250525 (opens in new tab)510(k)2025-11-14
Second Opinion Panoramic
K243234 (opens in new tab)510(k)2025-06-12
Second Opinion CS
K243989 (opens in new tab)510(k)2025-05-23
Second Opinion 3D
K243230 (opens in new tab)510(k)2025-05-09
Second Opinion BLE
K243893 (opens in new tab)510(k)2025-05-05
Second Opinion Pediatric
Show 3 more
K242600 (opens in new tab)510(k)2025-04-11
Second Opinion Periapical Radiolucency Contours
K242522 (opens in new tab)510(k)2025-01-16
Second Opinion CC
K210365 (opens in new tab)510(k)2022-03-04
Second Opinion
Subtle Medical
FDA decisions
K254120 (opens in new tab)510(k)2026-05-15
SubtleHD-CT 1.x
K254013 (opens in new tab)510(k)2026-05-14
SubtleHD-PET 1.x
K243250 (opens in new tab)510(k)2025-02-12
SubtleHD 1.x
K240290 (opens in new tab)510(k)2024-08-21
AiMIFY 1.x
K241329 (opens in new tab)510(k)2024-07-11
SubtleSYNTH 1.x
Show 6 more
K233699 (opens in new tab)510(k)2024-04-29
SubtleREFORMAT 1.x
K223623 (opens in new tab)510(k)2023-05-11
SubtleMR 2.3.x
K211964 (opens in new tab)510(k)2021-09-28
SubtlePET
K203182 (opens in new tab)510(k)2021-02-26
SubtleMR
K191688 (opens in new tab)510(k)2019-09-16
SubtleMR
K182336 (opens in new tab)510(k)2018-11-30
SubtlePET
Peer-reviewed
1 PubMed record names Subtle Medical.
Compliance and integrations
Documented from each vendor’s own pages.
| Spec | Pearl | Subtle Medical |
|---|---|---|
| Free tier | ||
| HIPAA | ||
| SOC 2 Type II | ||
| EHR integrations | Not specified | Not specified |
| Founded | 2019 | n/a |
| HQ | US | n/a |
Scroll horizontally to see both columns.
Common questions
Open the full radiology comparison
Acute-care triage, mammography screening, CCTA plaque analysis, mobile MRI. 30+ FDA-cleared platforms across stroke, oncology, cardiac. Enterprise sales only — we compared what's deployed where.