Study finds rapid growth in mammo CAD utilization

U.S. radiologists are increasingly turning to computer-aided detection (CAD) technology to improve breast cancer detection, according to research published in the October issue of the Journal of the American College of Radiology.

A team of researchers led by Vijay Rao, MD, of Thomas Jefferson University in Philadelphia surveyed U.S. Medicare databases and found that mammography CAD utilization grew 91% from 2004 to 2008. They also discovered that CAD was employed in nearly three out of four screening mammography studies, and in half of all diagnostic mammography exams in 2008.

"Although there remains debate over the efficacy of CAD, it is apparent that radiologists are increasingly utilizing this technology and that it is becoming standard practice in breast diagnosis," the researchers wrote.

To determine the extent and breadth of CAD use in screening and diagnostic mammography, the study team searched the Medicare Part B fee-for-service databases for 2004 to 2008, using CPT codes for screening and diagnostic mammography and CAD add-on codes. Both digital and film-screen exams were included (JACR, October 2010, Vol. 7:10, pp. 802-805).

Growth in screening CAD volume, 2004-2008
2004 2008 Difference
Total screening mammography studies 5,728,419 5,827,326 2%
Screening studies with CAD 2,257,434 4,305,595 91%

As a result, CAD was used in 74% of screening exams in 2008, up from 39% in 2004.

The researchers also discovered an increase in CAD utilization in diagnostic mammography exams.

Growth in diagnostic CAD volume, 2004-2008
2004 2008 Difference
Total diagnostic mammography studies 1,835,700 1,682,026 -8%
Diagnostic studies with CAD 360,483 845,461 135%

Therefore, CAD utilization rose from use in 20% of diagnostic studies in 2004 to 50% in 2008.

In other findings, the researchers concluded that women are somewhat more likely to have CAD if they receive their exams in private offices.

2008 CAD utilization by practice type
Screening studies Screening studies with CAD CAD usage Diagnostic studies Diagnostic studies with CAD CAD usage
Hospital outpatient facility 3,607,252 2,508,516 70% 1,073,370 511,981 48%
Private office 2,194,647 1,779,259 81% 596,952 328,788 55%

"This may be because some hospitals are reluctant to make the investment in CAD, whereas radiology groups that own offices or imaging centers have more control over their capital budgets and have decided that the investment is worthwhile," the authors wrote. "Alternatively, private office radiologists might see CAD as a way to increase mammography revenues because in 2008, Medicare's global reimbursement for CAD was $16.50."

By Erik L. Ridley
AuntMinnie.com staff writer
October 1, 2010

Related Reading

FFDM plus MRI boosts mammography CAD performance, September 28, 2010

Many radiologists favor double reading over mammo CAD, September 23, 2010

Double readers top CAD in finding breast tissue deformities, July 26, 2010

U.K. study finds mammo CAD can save money, November 9, 2009

Why are correct CAD marks ignored? It's anybody's guess, November 9, 2009

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