PET use by nonrads growing rapidly

Nonradiologists are ordering PET studies on scanners they either own or lease at nearly triple the growth rate of radiologists, contributing to issues of self-referral and unnecessary utilization of imaging in the U.S., according to a study published in the March issue of the Journal of the American College of Radiology.

Lead author Dr. Rajan Agarwal from the University of Pennsylvania School of Medicine in Philadelphia said the growth in PET purchases follows the same trend seen in recent years of more nonradiologists buying other types of advanced imaging modalities, such as CT and MRI.

He added that self-referral among nonradiologist physicians, which has resulted in unnecessary utilization of imaging, is one of the factors contributing to rising imaging costs.

Researchers collected data from the Medicare Part B Physician/Supplier Procedure Summary Master Files for 2002 through 2007 to calculate the number of PET scans performed on units owned or leased by various medical specialists, including radiologists.

While the overall imaging growth rate of 2% or less annually since 2006 is in line with or below that of other physician services, PET utilization by nonradiologists continues to significantly outpace that of radiologists.

Between 2002 and 2007, the authors noted, the number of scans performed on PET systems owned by radiologists increased by 259%, while scans performed on systems owned or leased by nonradiologists grew by 737%.

At a time when the costs of imaging and the exposure of patients to radiation are coming under intense scrutiny, Agarwal said it is of "great concern" that many nonradiologist physicians are going outside the scope of their original specialty training and practice experience by acquiring and leasing advanced imaging equipment such as PET scanners.

Related Reading

One-quarter of outpatient CT and MR exams are inappropriate, March 1, 2010

CDC report: MRI, CT, PET use spikes in physician offices, ER, February 18, 2010

NEJM study: Imaging procedures, radiation growing, August 26, 2009

MedPAC: Self-referring docs use more imaging, June 23, 2009

Imaging self-referral: An inside manifesto, March 19, 2009

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