Ventilation-perfusion (V/Q) scans: trends from medicare part B (2013-2023)

Area of Science:

• Nuclear Medicine
• Radiology
• Pulmonary Medicine

Background:

• Ventilation-Perfusion (V/Q) scans are a key diagnostic tool for pulmonary embolism (PE), particularly when computed tomography pulmonary angiography (CTPA) is contraindicated.
• Utilization of V/Q scans in the United States has shown a declining trend.

Purpose of the Study:

• To analyze national Medicare data from 2013-2023 to assess trends in V/Q scan utilization.
• To evaluate physician procedure volumes for V/Q scans.
• To identify factors potentially impacting the diagnostic quality of V/Q imaging.

Main Methods:

• Analysis of national Medicare claims data spanning from 2013 to 2023.
• Assessment of annual V/Q scan utilization rates.
• Examination of the volume of scans read by physicians, categorizing them as low-volume readers.

Main Results:

• A consistent decline in annual V/Q scan utilization was observed from 2013 to 2023.
• A significant drop in V/Q scan usage occurred between 2019 and 2020, coinciding with the COVID-19 pandemic.
• The proportion of V/Q scans read by low-volume readers (<11 scans/year) increased substantially, from 20.3% in 2013 to 43.4% in 2023.

Conclusions:

• The declining use of V/Q scans and the increasing prevalence of low-volume readers raise concerns about diagnostic quality.
• There is an urgent need to re-evaluate training programs, competency standards, and accessibility of V/Q imaging for patients with CTPA contraindications.