Robert J. McDonald MD, PhD, Presenter: Nothing to Disclose

Kara Michelle Schwartz MD, Abstract Co-Author: Nothing to Disclose

Felix E. Diehn MD, Abstract Co-Author: Nothing to Disclose

Laurence J. Eckel MD, Abstract Co-Author: Nothing to Disclose

Christopher Harker Hunt MD, Abstract Co-Author: Nothing to Disclose

Bradley J. Erickson MD, PhD, Abstract Co-Author: Stockholder, Evidentia Health, Inc

David F. Kallmes MD, Abstract Co-Author: Research support, Terumo Corporation Research support, Covidien AG Research support, Sequent Medical, Inc Research support, Benvenue Medical, Inc Consultant, General Electric Company Consultant, Covidien AG Consultant, Johnson & Johnson

Cross-sectional imaging utilization has dramatically increased over the past two decades. Driven by technical innovations that have improved anatomic resolution, acquisition time, and applicability of CT and MRI, cross sectional modalities have supplanted use of conventional radiographs in many clinical practice guidelines. Rising utilization coupled with innovation has increased Radiologists’ workload through with respect to the total number of studies and images that must be interpreted. In the current study, we quantified changes in imaging workload over time as a surrogate measure of fatigue.

Monthly counts of CT and MRI studies performed at our institution from1999-2010 were identified. Total numbers of images per exam were also extracted from the associated studies. Imaging workload data were normalized to the number of dedicated CT and MRI daily work assignments to determine the average radiologist workload assuming a 255-work day calendar and 8-hour workday. Temporal trends in institutional and individual workload were assessed by Sen’s slope analysis (Q) using a normal Z-test statistic.

From 1999-2010, a total of 1,517,149 cross-sectional imaging studies (CT=994,471; MRI=522,678) comprised of 539,210,581 images (CT=339,830,947; MRI=199,379,634) were evaluated at our institution. Total numbers of annual cross-sectional studies steadily increased from 84,409 in 1999 to 147,336 in 2010, representing a two-fold increase in workload (Q=6465/yr, Z=4.2, p<.0001). Concomitantly, the total number of annual departmental cross-sectional images interpreted increased from 9,294,140 in 1990 to 94,271,551 in 2010, representing a ten-fold increase in number of images requiring interpretation (Q=8707876/yr, Z=4.5, p<.0001). Adjusting for staffing changes, the number of images requiring interpretation per minute of every workday per staff Radiologist increased from 2.9 in 1999 to 16.1 in 2010 (Q=1.7/yr, Z=4.3, p<.0001).

Imaging volumes have grown at a rate out of proportion to increasing imaging utilization at our institution. The average radiologist must now interpret 1 image every 2-3 seconds in a given 8-hour workday to keep up with workload demands.

Growing imaging volumes, and to a lesser extent increasing utilization, are likely major contributors to Radiologist fatigue.

McDonald, R, Schwartz, K, Diehn, F, Eckel, L, Hunt, C, Erickson, B, Kallmes, D, The Effect of Increasing Imaging Volumes on Radiologist Fatigue: The eFatigue Phenomenon.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13025296.html Accessed August 28, 2025