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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.

February 27, 2020

New Neiman Health Policy Institute Research Finds Significant Increase in CT Angiography Procedures

Reston, VA – Angiography is a critical tool in the diagnosis and treatment of vascular conditions of the extremities. By directly imaging blood vessels, angiography gives physicians a detailed understanding of a patient’s vascular anatomy and is particularly useful in the evaluation of artery diseases and trauma. This new study from Harvey L. Neiman Health Policy Institute, published online in Current Problems in Diagnostic Radiology, assesses the changing utilization of extremity angiography from 2001 to 2016, focusing on modalities and provider specialties.

“Using two distinct but complementary national Medicare claims databases, we demonstrated that total utilization of extremity angiography among the Medicare Fee-for-Service population grew nearly fifty percent from 2001 to 2016,” stated first author Phillip L. Guichet, MD, Interventional Radiology Resident at NYU Grossman School of Medicine. “This growth was largely due to the rapid adoption of noninvasive computed tomography (CT) and magnetic resonance (MR) angiographic techniques which have become widely available and rapidly adopted in the past two decades.”

Dr. Guichet and team leveraged CMS Medicare Physician and Other Supplier Public Use Files from 2001 through 2016 and Medicare Provider Utilization & Payment Data: Physician and Other Supplier for 2016 to determine overall and specialty utilization of diagnostic catheter angiography (DCA), CT angiography (CTA), and MR angiography (MRA).

From 2001 to 2016, extremity angiography increased from 1,107 to 1,590 extremities imaged per 100,000 beneficiaries, with rapid expansion of CTA from 22 in 2001 to 619 in 2009; plateau of 645 in 2016, with declines in DCA and MRA. Over time, extremity angiography shifted from primarily DCA (94%), with low rates of MRA, and CTA to 58% DCA, 41% CTA, and 2% MRA. Across specialty lines, shifts occurred in physicians’ chosen modalities of extremity angiography, with radiologists adopting and dominating the market in CTA and MRA utilization while ceding dominance in DCA to cardiologists and vascular surgeons.

“Radiology’s adoption of noninvasive means of extremity angiography has permitted radiologists to reach a larger number of patients and to do so more safely,” stated 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 affiliate senior research fellow. “With the increasing sub-specialization of medicine and the advent of the integrated IR/DR residency, it is important to keep in mind the value that general radiologists bring to ensuring robust access to high-quality patient care.”


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