Neuroimaging use is rising in emergency departments (EDs), according to research published June 24 in the American Journal of Roentgenology.
The proportion of ED encounters that received any neuroimaging, whether they be from CT or MRI, increased by over seven percentage points between 2016 and 2025, wrote a team led by Pranjal Rai, MD, from the Mayo Clinic in Rochester, MN.
“The observed contemporary increase… has implications for imaging costs, radiation exposure, workflow efficiency, and radiologist demands,” the Rai team wrote.
Prior research suggests that the use of neuroimaging is increasing in the ED. This may be due to evolving clinical practice patterns, advances in imaging technologies, and expanded imaging availability, the researchers noted. However, they also pointed out limited research that uses contemporary nationally representative data for a broad range of ED neuroimaging exams.
Rai and colleagues studied temporal shifts in the use of neuroimaging in the ED, using nationally representative data from a research platform (Cosmos, Epic Systems). They included 16 neuroimaging exam types, including those using CT, CT angiography (CTA), and MRI.
Final analysis included 1,030,277 neuroimaging exams and 3,980,847 ED encounters between 2016 and 2025.
The proportion of ED encounters that received any neuroimaging increased from 10.6% to 16.8% throughout the study period. And the average number of neuroimaging exams per ED encounter with any neuroimaging increased slightly from 1.6 to 1.9.
And neuroimaging use per 1,000 ED encounters increased for most imaging types.
Neuroimaging utilization per 1,000 ED encounters by year | ||
Neuroimaging exam | 2016 | 2025 |
All neuroimaging | 175 | 316 |
Non-contrast head CT | 86 | 129 |
Head-and-neck CTA | 12 | 52 |
Spine CT | 33 | 70 |
Other CT | 13 | 22 |
Head MRI | 16 | 24 |
Spine MRI | 8 | 14 |
Other MRI | 7 | 5 |
The team attributed the growth in CTA use to expanded CT-based emergency neurovascular workflows after the implementation of widespread thrombectomy. This includes code-stroke pathways and broader use of CTA-based triage in trauma imaging.
The results could help inform infrastructure planning for ED imaging, as well as training program capacities and neuroradiology workforce targets, the authors highlighted.
“The need for 24/7 rapid interpretations amplifies the challenges that the utilization growth creates for emergency radiology services,” they wrote.
Read the full study here.
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