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The mission of the Harvey L. Neiman Health Policy Institute® is to establish foundational evidence for health policy and radiology practice that promotes the effective and efficient use of health care resources and improves patient care.

July 10, 2020

Study Finds Oncologic Imaging Steadily Increasing with Over 58% Performed in Hospital Out Patient Setting

Reston, VA – Imaging today plays essential roles in the management of almost all non-cutaneous cancers, influencing diagnosis, assessment of prognosis, treatment selection, and therapeutic monitoring. Achieving consistently high-quality oncologic imaging (OI) interpretations poses an increasing challenge in light of the growing complexity of such imaging and of oncologic care. This new Harvey L. Neiman Health Policy Institute study, published on in the Journal of the American College of Radiology (JACR), characterizes national trends in oncologic imaging utilization.

“In recent years, there have been rapid advances in cancer diagnosis and treatment including the introduction of new technologies, changes in standard treatment protocols, and a shift toward the implementation of precision medicine based on a growing understanding of tumor biology,” stated lead author Hedvig Hricak, MD, PhD, chair of the department radiology at Memorial Sloan Kettering Cancer Center. “This study is the first to use a national claims database to gather information on the share of radiologist-performed diagnostic imaging done for oncologic indications in the U.S. and on the distribution of such imaging among different care settings.”

Hricak and her colleagues used 2004 and 2016 CMS 5% Research Identifiable Files in this study. These files contain all Medicare Part B claims for a 5% random sample of Medicare fee-for-service beneficiaries. Radiologist-performed, primary non-invasive diagnostic imaging exams were identified from billed codes; CT, MRI and PET/CT examinations were categorized as “advanced” imaging.

The researchers found that oncologic imaging usage varied between practice settings. While the percentage of advanced OI done in academic settings nearly doubled from 2004 to 2016, the majority remained in non-academic practices. In addition, at the state level, the utilization of advanced OI was correlated with the state supply of radiologists in 2016, but not with states’ cancer prevalence.

“These findings indicate that strategies are warranted to disseminate oncologic imaging expertise throughout the radiology community,” said Andrew Rosenkrantz, MD, MPA, lead study author, professor and director of health policy in the department of radiology at NYU Grossman School of Medicine and a Neiman Institute senior affiliate research fellow. “They also highlight a need for stricter application of evidence-based cancer imaging guidelines nationwide.”


To obtain a copy of the study or to arrange an interview with a Neiman Institute spokesperson, contact Nichole Gay at (703) 648-1665 or


About the Harvey L. Neiman Health Policy Institute

The Harvey L. Neiman Health Policy Institute® is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care.Visit us at and follow us on Twitter, LinkedIn and Facebook.


Nichole Gay
Harvey L. Neiman Health Policy Institute