Neuroimaging utilization in emergency departments has increased year-over-year for a decade
A new analysis is offering detailed insight into how the utilization of neuroimaging has changed throughout the last decade, highlighting emergency providers’ growing preference for CT studies.
Research on the utilization of neuroimaging use in emergency settings is not new; numerous analyses on the topic have been published in recent years, but the authors of a new paper in the American Journal of Roentgenology point out that these studies have either been small in sample size, based on the influence of insurance coverage or specific to a small subset of specialized studies. As such, there has been an unmet need for new data relevant to the wide breadth of modern radiology workflows.
“Investigation using contemporary nationally representative data for abroad range of ED neuroimaging examinations remains limited,” Pranjal Rai, MD, with the Department of Radiology at Mayo Clinic, Rochester, and colleagues noted. “Such analysis could help inform planning of ED imaging infrastructure, training program capacities, and neuroradiology workforce targets. This study aimed to evaluate temporal shifts in ED neuroimaging utilization using a nationally representative dataset.”
The retrospective analysis included over 1 million neuroimaging studies completed at more than 2,000 facilities across the United States between 2016 and 2025. The details of each case, including the modality utilized, type of exam performed and clinical indication, were compared.
Between 2016 and 2025, ED encounters involving neuroimaging of any sort increased from 10.6% to 16.8%; total neuroimaging exams per 1,000 ED encounters rose from 175 to 316. CT was utilized more often (it more than doubled over the decade), but increases were seen across both CT and MRI.
Noncontrast head CT examinations per 1,000 ED encounters spiked from 86 to 219, while head and neck CTA exams per 1,000 increased from 12 to 52 and CT exams of the spine from 33 to 70. MRIs of the head per 1,000 encounters rose from 12 to 22 and spinal MRIs saw an increase of six exams per 1,000 encounters.
The authors suggested that their analysis more accurately reflects how neuroimaging in the ED has evolved over time, adding that the data could be used to better inform staffing coverage in radiology departments.
“The observed contemporary increase in encounter-adjusted ED neuroimaging utilization using the Cosmos EHR platform has implications for imaging costs, radiation exposure, workflow efficiency, and radiologist demands,” the team suggested. “The need for 24/7 rapid interpretations amplifies the challenges that the utilization growth creates for emergency radiology services.”
The full analysis is available here behind a paywall.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.