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Use of MRI, CAT scans rising in hospital emergency rooms

By Mike Stobbe
Associated Press / February 18, 2010

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ATLANTA - The use of high-tech diagnostic imaging in emergency rooms has quadrupled since the mid-1990s, according to a government report released yesterday.

MRI, CAT, or PET scans were done or ordered in 14 percent of ER visits in 2007, the report from the Centers for Disease Control and Prevention found. That’s four times as often as in 1996.

The frequency of the medical scans nearly tripled at doctors’ offices and outpatient clinics, to about 3 percent.

There are more and better scanning machines available today than in the 1990s, the report’s authors noted. The scans provide a much clearer picture of problems inside the body than was available in the past, experts said.

But health officials and others worry about the safety and cost of all that scanning.

“I wish I had an answer as to whether that’s great news or bad news,’’ Dr. Rita Redberg, a cardiologist at the University of California, San Francisco, said of the increased use. Redberg, who has written about safety concerns of using CAT scans, called the new statistics “astounding.’’

Without firm guidelines as to when the scans are medically necessary, it’s hard to say whether the increased use is excessive, Redberg and others said.

The CDC’s National Center for Health Statistics reported the numbers in its annual summary of US data on disease conditions, health behaviors, and use of medical services. The scan figures are based on visits to about 500 hospitals and 3,000 doctors’ offices and outpatient clinics.

Researchers counted three kinds of scans: MRIs, or magnetic resonance imaging, which use powerful magnets and radio waves, CAT scans, or computerized axial tomography, which combine X-rays with sophisticated computers, and PET scans, or positron-emission tomography, which use X-rays and a radioactive substance.

The scans are expensive - a single CAT scan can cost $500 to $1,000, and MRIs and PET scans can be much more expensive. The federal Medicare program has been trying to hold down imaging costs since its annual bill reached $12 billion.

Studies have not yet clearly demonstrated that the scans are lowering death rates, said Redberg, who is editor of the Archives of Internal Medicine.

There also is concern about radiation from scanners.