Increased use of CT drove a boom in medical imaging utilization in the emergency department setting over the past 10 years. That’s according to a new study in Radiology that comes amid increased scrutiny over the long-term health effects of CT radiation.
CT is tailor-made for evaluating patients in the emergency setting. It’s fast, relatively inexpensive, and provides high-quality images that can deliver a diagnosis quickly.
- For these reasons, emergency departments have been quick to install workhorse CT scanners running at all hours in the hope that faster diagnoses will lead to better patient outcomes.
But there are also downsides to the growth in CT utilization. It can put strains on radiology departments to read all the new scans – a particular challenge in an era of workforce shortages.
- Concerns about the link between CT radiation dose and cancer also persist. Two controversial studies were published this year on the subject, one linking CT to future cancers across the U.S. population and the other specifically to pediatric blood cancer.
The new study offers a useful benchmark for tracking CT’s growth in the ED. Researchers chronicled changes in U.S. emergency imaging use in Medicare from 2013 to 2023, finding that per 100 Medicare beneficiaries…
- CT use grew 96% (37 vs. 19 encounters).
- While ultrasound only grew 20% (2.8 vs. 2.3 encounters).
- And radiography use remained flat at 37 encounters in both years.
In addition, the number of overall ED encounters actually declined 16% (55 vs. 65 encounters), showing that imaging’s growth was due to more imaging per ED encounter rather than overall increased ED visits by beneficiaries.
- On a per-encounter basis, CT use grew 134% over the study period compared to 43% for ultrasound and 19% for radiography.
Researchers believe that the difference in modality growth rates could be due to the use of CT to accelerate patient turnover in the ED.
- Meanwhile, ultrasound use may have grown more modestly due to the proliferation of point-of-care handheld scanners among non-radiologists.
The Takeaway
The new findings underscore the conundrum behind emergency CT – it’s an incredibly powerful technology that nevertheless requires restraint in order to be used judiciously. Let’s hope emergency physicians take note.
