BY JAMES M. BRICE

Radiology is moving slowly but surely from plain film to cross-sectional imaging, according to an analysis of fiscal 1993 and 1996 data from 172 VA hospitals.

The research, described Monday at the RSNA meeting by Dr. Bruce Reiner and Dr. Eliot Siegel of the Baltimore VA Medical Center, found that general radiographic exams performed at VA hospitals decreased 13.4% between fiscal 1993 and 1996. This drop contributed to a 7.9% decline in the total number of inpatient and outpatient exams performed in the VA system.

The results are consistent with changes in the utilization mix observed at Massachusetts General Hospital in 1998. CT accounted for 30% of RVUs in the MGH radiology department, according to Dr. James Thrall, radiologist-in-chief. Cross-sectional methods in aggregate accounted for 66% of the department's RVUs. A similar case mix is the destiny of most community hospitals, according to Siegel.

"My prediction is that in five to 10 years more than half the studies done in radiology will be cross-sectional imaging, where it used to be that 70% were general radiography. This means that in acquiring equipment, the trend should be away from general radiography rooms and fluoro rooms in favor of spiral CT and other technology," he said.