Study Analyzes a Decade of Cardiac Imaging Trends

Study Analyzes a Decade of Cardiac Imaging Trends

September 28, 2021 — A new study released in Radiology: Cardiothoracic Imaging on cardiac imaging patterns over a years reports that the rate of coronary computed tomography angiography (cCTA) tests by radiologists in health center outpatient departments increased markedly from 2010 to 2019, recommending a bright future for the innovation. The research study also found that repayment cuts and advances in technology have assisted move much of the imaging done by cardiologists from the workplace to health center outpatient department.
Imaging has long played an important role in the diagnosis of cardiovascular illness, the leading killer worldwide. Both cardiologists and radiologists carry out noninvasive cardiac imaging, however with time two of the most common heart imaging approaches, echocardiography and myocardial perfusion imaging, became nearly exclusively the domain of cardiologists.
The dominance was partially due to a cardiologists distinct position as a service provider who both orders and carries out diagnostic cardiac imaging. Compensation cuts from the Deficit Reduction Act (DRA) of 2005 had a significant impact on in-office cardiac imaging.
” In the early 2000s, cardiology workplace imaging usage was increasing,” said research study lead author Russell A. Reeves, M.D., from the Center for Research on Utilization of Imaging Service (CRUISE) and diagnostic radiology resident in the Department of Radiology at Thomas Jefferson University in Philadelphia. “The changes brought by DRA reversed that pattern to where it no longer was financially rewarding or perhaps feasible for a great deal of cardiologists to do imaging in their offices.”
During that very same period, technological advances made competing imaging exams traditionally performed by radiologists, such as cCTA, appealing alternatives.
Reeves and coworkers studied information from the 2010-2019 Physician Supplier Procedure Summary files to assess the impact of these advancements on utilization of various kinds of cardiac imaging.
They discovered that cardiologist in-office myocardial perfusion imaging rates per 100,000 Medicare recipients came by 52%, from 4,426 to 2,119, over the 10-year period. Alike, imaging rates per 100,000 recipients at medical facility outpatient departments rose 71%, from 935 to 1,598.
” Cardiologists are not performing almost as lots of myocardial perfusion scans as they were, and a lot of are now being done at health center outpatient imaging departments,” Reeves said.
Over the same duration, the rates of cCTA by radiologists in medical facility outpatient departments increased by 355%. Overall rates, however, stayed low compared to myocardial perfusion imaging, despite the truth that some studies have actually shown cCTA to be more precise. The innovations uptake may be limited, Reeves stated, by its complexity and the cost of equipment, in addition to the reality that it requires a devoted technologist.
Still, he said, the increasing rate of cCTAs performed by radiologists represents a growing opportunity for collaboration in cardiac imaging. Recently at Thomas Jefferson, cardiologists have actually revealed interest in reading cCTA examinations side-by-side with radiologists to improve patient care.
” Coronary CTA is a helpful screening tool for coronary artery disease that obviates the need for intrusive coronary angiography,” Reeves stated. “I think the future is looking positively on it.”
Rates of heart PET (cPET) in cardiologist offices increased by 193% over the 10-year period, but cardiac PET carried out by radiologists in workplaces and health center outpatient departments saw little change. The increase in in-office cPET is most likely due to a combination of technological advances, analysis familiarity and financial incentives, according to Reeves.
Reeves plans to continue following the trends to study the impact of regulative, other and economic factors on imaging usage.
” Ultimately, we as radiologists need to be self-regulators and likewise do the research to support modification, to help the specialty and assistance medical practices overall in the future,” he stated.
The research study is also a way of honoring the tradition of Reeves mentor, David Levin, M.D., professor and chairman emeritus at Thomas Jefferson University. Levin, a former fighter pilot who ended up being a leading researcher in imaging usage patterns and established CRUISE, passed away in 2020.
For more details: www.radiologyinfo.org
This material was originally published here.


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