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National Trends in Oncologic Diagnostic Imaging.

Andrew B Rosenkrantz1, Laura Chaves Cerdas2, Danny R Hughes3

  • 1Section chief, Abdominal Imaging, Director of Health Policy, and Director of Prostate Imaging, Department of Radiology, NYU Langone Health, New York, New York.

Journal of the American College of Radiology : JACR
|July 9, 2020
PubMed
Summary

Oncologic imaging utilization increased in academic settings but remained mostly nonacademic. Advanced oncologic imaging correlated with radiologist supply, not cancer prevalence, indicating practice patterns influence access.

Keywords:
Advanced imagingMedicarehealth services researchoncologic imagingutilization

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Area of Science:

  • Radiology and Imaging
  • Oncology
  • Health Services Research

Background:

  • Oncologic imaging (OI) is crucial for cancer diagnosis, staging, and treatment monitoring.
  • Understanding trends in advanced OI utilization is essential for resource allocation and healthcare policy.
  • Previous studies have not comprehensively analyzed national trends in OI across different practice settings.

Purpose of the Study:

  • To characterize national trends in the utilization of oncologic imaging (OI).
  • To examine the correlation between advanced OI utilization and factors like practice setting, radiologist supply, and cancer prevalence.
  • To analyze shifts in advanced OI provision between academic and nonacademic practices over time.

Main Methods:

  • Retrospective cross-sectional study using 2004 and 2016 Medicare claims data.
  • Identified diagnostic imaging examinations and categorized CT, MRI, and PET/CT as advanced OI.
  • Assessed state-level correlations between advanced OI utilization, cancer prevalence, and radiologist supply.

Main Results:

  • Advanced OI constituted 9.5%-10.8% of all advanced imaging in 2016 and 2004, respectively.
  • The proportion of advanced OI performed in academic practices significantly increased from 18.8% (2004) to 34.1% (2016).
  • In 2016, 58.0% of advanced OI occurred in hospital outpatient settings, and utilization correlated with radiologist supply (r=+0.489, P<.001) but not cancer prevalence (r=-0.139, P=.329).

Conclusions:

  • While academic centers increased their share of advanced OI, the majority is still performed in nonacademic settings.
  • Advanced oncologic imaging utilization is linked to the availability of radiologists rather than the burden of cancer prevalence at the state level.
  • Findings highlight practice setting variations and the influence of radiologist supply on advanced OI access.