Strong Competition Between CCTA And MPI Growth Rates.

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CCTA_imagingA new study, presented at the RSNA meeting in November, mentioned that the use of coronary CT angiography (CCTA) has fallen faster than that of radionuclide myocardial perfusion imaging (MPI). According to David Levin, MD, and colleagues from Thomas Jefferson University in Philadelphia, CCTA gives information more than MPI scans, and perhaps it is a sign of underutilization in the U.S. due to the lower rates of CCTA utilization compared to that of MPI rates.

Levin said, during an interview, "Although an MPI test can be negative, the patient can still have significant coronary artery disease, while if a CTA is negative the patient can be sure that he doesn't have coronary artery disease". A comparison between CCTA utilization trends and MPI was made by Levin and colleagues using Medicare Physician/Supplier Procedure Summary Master Files from 1998 to 2008. They followed the MPI growth rates from 1998 to 2008 and CCTA rates from 2006 to 2008. Also they used Medicare physician specialty codes in order to determine studies performed by radiologists and cardiologists.

Levin told attendees at the RSNA that CCTA is a common new technique that has attracted the attention of both radiologists and cardiologists. CCTA and MPI now are two competing techniques that are used for imaging patients with suspected coronary artery disease. He added that "CCTA exams are being done by cardiologists more than radiologists".

It was found that MPI rates per 100,000 beneficiaries among radiologists were 1,906 in 2006, 1,736 in 2007, and 1,601 in 2008, while among cardiologists, the MPI rates were 6,168 in 2006, 6,174 in 2007, and 6,228 in 2008. Levin commented "In both 2007 and 2008 we found a little reduction in the total MPI utilization. The radiologists understood clearly this reduction, while for cardiologists the rate remained essentially flat".

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