Emergency Neuroimaging Increased Considerably from 2007 to 2017

Leesburg, VA, August 4, 2021According to ARRS’ American Journal of Roentgenology (AJR), neuroimaging utilization in the emergency department (ED) increased substantially between 2007 and 2017, with the growth of head and neck CT angiography (CTA) outperforming other modalities. By far, unenhanced head CT remains the leading ED neuroimaging examination.

“The rapid growth of head and neck CTA observed in the fee-for-service Medicare population is also observed in the commercially insured and Medicare Advantage populations,” wrote corresponding author Selin Merdan from the department of industrial and systems engineering at the Georgia Institute of Technology in Atlanta.

Merdan and colleagues assessed annual ED utilization of head CT, head MR, head CTA, neck CTA, head MR angiography (MRA), neck MRA, and carotid duplex ultrasound using anonymized patient-level claims from the Clinformatics Data Mart (Optum) for 2007–2017. Annually, this database includes 12–14 million commercial and Medicare Advantage health plan enrollees. Utilization rates were adjusted using annual relative proportions of age groups and stratified according to patient demographics, payer type, and provider state.

For the decade under examination, age-adjusted ED neuroimaging utilization rates per 1,000 ED visits increased 72% overall (compound annual growth rate [CAGR] 5%). Specifically, the utilization of head CT and CTA of the head and neck continuously increased in those aged 65 or older by 48% (CAGR 4%) and 1,011% (CAGR 24%), far outpacing that of other neuroimaging modalities.

“The appropriateness of this growth should be monitored as the indications for CTA expand and more incidental findings are uncovered,” the authors of this AJR article cautioned.

An electronic supplement to this AJR article is available here

Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiological society in North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress in medical imaging since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, AJR Live Webinars and Podcasts, topical symposia, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.