Vijay Madan Rao MD, Presenter: Nothing to Disclose

David C. Levin MD, Abstract Co-Author: Consultant, HealthHelp Board of Directors, Outpatient Imaging Affiliates, LLC

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Andrea J. Frangos MPH, Abstract Co-Author: Nothing to Disclose

Jonathan H. Sunshine PhD, Abstract Co-Author: Nothing to Disclose

To compare usage of CTA and MRA in diagnosing diseases of the chest (noncardiac), abdomen, and lower extremities (LEs), and to determine how quickly these modalities are growing and who performs them.

The nationwide Medicare Part B fee-for-service databases for 2002-2007 were used. The individual CPT-4 codes for CTA and MRA of the chest and abdomen were selected, as were the 3 CTA codes and the 2 MRA codes for the pelvis and LEs. Procedure volume was determined for each year and growth trends were plotted. Medicare physician specialty codes were used to ascertain how many of these studies were performed by radiologists or other providers.

In noninvasive angiography of the chest (noncardiac) in the Medicare population in 2007, there were 502,086 CTAs and 7975 MRAs. Between 2002 and 2007, chest CTA grew by 482%, compared with 85% for chest MRA. In the abdomen in 2007, there were 160,585 CTAs and 79,343 MRAs. Growth from 2002-2007 was 484% for abdominal CTA and 95% for abdominal MRA. Volume of CTAs of the pelvis and LEs in 2007 was 186,789, compared with 76,204 MRAs. Growth from 2002-2007 was 728% for pelvic/LE CTA and 237% for pelvic/LE MRA. From 2006 to 2007, there was a substantial decrease in MRA volume in all 3 body areas, but CTA volume continued to increase that year. In 2007, radiologists’ market shares were 93% for CTA and 90% for MRA. The most actively involved among other specialists in 2007 were cardiologists ( 4% share of CTA and 2% share of MRA).

The greatest noncardiac, noncerebral use of noninvasive angiography is in the thorax and CTA is far more widely used there than MRA. CTA is also used more widely than MRA in the abdomen and the pelvis/LEs, by approximately a 2:1 ratio. CTA is growing more rapidly than MRA in all body 3 areas. In the final year of the study, MRA volume declined, while CTA volume continued to increase. Radiologists strongly predominate in performing these procedures.

Does not apply.

Rao, V, Levin, D, Parker, L, Frangos, A, Sunshine, J, Variations in Usage of CT Angiography (CTA) and MR Angiography (MRA) for Evaluating Thoracic, Abdominal, and Peripheral Arteries.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8002782.html