Purpose <p>The impact of social media dissemination on the citation of scientific papers in the field of diagnostic imaging and radiation oncology has not yet been established. We aimed to evaluate the impact of alternative metrics on citation counts and to identify the most influential predictors of citation impact across social media platforms.</p> Methods <p>We selected original papers published between 2015 and 2019 in six reference journals in the field of diagnostic imaging and radiation oncology. Social media attention was quantified using the Altmetric Attention Score (AAS) and its indicators (mentions in news, blogs, Facebook posts, Twitter posts and accounts, and any online document that links to one or more research objects), provided by Altmetric. Citation counts were retrieved from Scopus. Descriptive analysis was used to extract essential information for subsequent regression analysis to predict citations. We tested three models to assess the relationship between AAS and citations. A p-value below 0.05 was considered statistically significant.</p> Results <p>We analyzed 4778 papers. AAS alone did not predict citation counts. The time since publication had the strongest influence on the number of citations. Among social platforms, Facebook emerged as the most influential, but it was surpassed by Twitter when considering Twitter accounts and Twitter posts collectively.</p> Conclusion <p>AAS and its indicators cannot be considered sole predictors of citation counts.</p>