HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lee, S. I. Articles by Hahn, P. F. Search for Related Content PubMed PubMed Citation Articles by Lee, S. I. Articles by Hahn, P. F.

Does Radiologist Recommendation for Follow-up with the Same Imaging Modality Contribute Substantially to High-Cost Imaging Volume?¹

¹ From the Department of Radiology (S.I.L., A.S., K.J.D., J.H.T., P.F.H.) and Massachusetts General Physician's Organization (J.B.W.), Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114. From the 2004 RSNA Annual Meeting. Received October 27, 2005; revision requested December 22; revision received May 17, 2006; final version accepted July 14. Address correspondence to S.I.L.

Purpose: To retrospectively measure repeat rates for high-cost imaging studies, determining their causes and trends, and the impact of radiologist recommendations for a repeat examination on imaging volume.

Materials and Methods: This HIPAA-compliant study had institutional review board approval, with waiver of informed consent. Repeat examination was defined as a same-modality examination performed in the same patient within 0 days to 7 months of a first examination. From a database of all radiology examinations (>2.9 million) at one institution from May 1996 to June 2003, a computerized search identified head, spine, chest, and abdominal computed tomographic (CT), brain and spine magnetic resonance (MR) imaging, pelvic ultrasonography (US), and nuclear cardiology examinations with a prior examination of the same type within 7 months. Examination pairs were subdivided into studies repeated at less than 2 weeks, between 2 weeks and 2 months, or between 2 and 7 months. Automated classification of radiology reports revealed whether a repeat examination from June 2002 to June 2003 had been preceded by a radiologist recommendation on the prior report. Trends over time were analyzed with linear regression, and 95% confidence intervals were calculated.

Results: Between July 2002 and June 2003, 31 111 of 100 335 examinations (31%) were repeat examinations. Body CT (9057 of 20 177 [45%] chest and 8319 of 22 438 [37%] abdomen) and brain imaging (6823 of 18 378 [37%] CT and 3427 of 11 455 [30%] MR imaging) represented the highest repeat categories. Among five high-cost, high-volume imaging examinations, 6426 of 85 014 (8%) followed a report with a radiologist recommendation. Most common indications for examination repetition were neurologic surveillance within 2 weeks and cancer follow-up at 2–7 months. From 1997 to mid-2003, MR imaging and CT repeat rates increased (0.71% per year [P < .01] and 1.87% per year [P < .01], respectively).

Conclusion: Repeat examinations account for nearly one-third of high-cost radiology examinations and represent an increasing proportion of such examinations. Most repeat examinations are initiated clinically without a recommendation by a radiologist.

© RSNA, 2007