Radiologists Still Primary Noncardiac Ultrasound Users

While the “ultrasound stethoscope” may indeed be moving from science fiction to reality, radiologists remain at the helm for the majority of ultrasound procedures. That’s despite the growth of bedside point-of-care ultrasound, according to a new study published the November issue of the Journal of the American College of Radiology.

The idea for the new study was sparked by a Feb. 24, 2011 review article appearing in the New England Journal of Medicine, said author David C. Levin, MD. In the February review, authors Christopher L. Moore, MD, and Joshua A Copel, MD, said miniaturization and falling costs have sparked the growth of noncardiac point-of-care ultrasound by clinicians, and that the concept of an “ultrasound stethoscope” is rapidly moving from the theoretical to a reality.

“The commentary by Moore and Copel raises the question of how widespread the use of noncardiac ultrasound has become among nonradiologist physicians and how quickly such use is growing with the advent of hand-carried ultrasound devices. We used a nationwide database to investigate these questions,” Levin said.

To determine the rate of utilization of noncardiac ultrasound by radiologists and other specialists, researchers at Thomas Jefferson University looked at Medicare Part B databases for 2004 to 2009. Between 2004 and 2009, they found a 21 percent increase in the overall use of non-cardiac ultrasound. Point-of-care ultrasound by non-radiologists amounted to 41 percent of all studies done in 2009, while radiologists performed 55 percent. Multiple non-radiologic specialties are involved, but radiologists’ involvement is far higher than any other single specialty, Levin and colleagues found.

Between 2004 and 2009, radiologists’ utilization rate increased by 17 percent, compared with 28 percent for nonradiologists, the study further found. Radiologists’ market share of noncardiac ultrasound fell slightly, from 56.6 percent in 2004 to 54.9 percent in 2009. Other major specialties involved in point-of-care ultrasound and their 2009 rates per 1,000 and percentage increases since 2004:

• cardiology (39.7, up 60 percent)
• vascular surgery (34.9, up 36 percent)
• primary care (27.2, up 11 percent)
• general surgery (24.2, up 8 percent), and
• urology (22.3, up 12 percent).

“The role of radiologists in noncardiac ultrasound remains quite strong; however progressive miniaturization of ultrasound equipment may change that. As a result, utilization trends will require further watching and additional research in the coming years,” said Levin.