Ownership/Leasing of PET Scanners by Nonradiologists on the Rise

Just as with computed tomography (CT) and magnetic resonance imaging (MRI), the growth rate among nonradiologists who own or lease positron emission tomography (PET) equipment is also on the rise, contributing significantly to the ongoing issues surrounding self-referral and unnecessary utilization of imaging in the United States, according to new data.

PET is a comparatively new technology that produces three-dimensional images of functional processes in the body. It is often used to diagnose specific types of cancer and heart disease. "One of the well-known factors contributing to rising imaging costs is self-referral among nonradiologist physicians, which has been shown to result in unnecessary utilization of imaging,” said Rajan Agarwal, M.D., MBA, from the University of Pennsylvania (Philadelphia, USA) and lead author of the study. "This has made imaging one focus of concern as policymakers and third party payers look to cut health care costs,” said Dr. Agarwal.

Data were collected utilizing the Medicare Part B Physician/Supplier Procedure Summary Master Files for 2002 through 2007. The number of PET scans performed on units owned or leased by various medical specialists, including radiologists was tabulated. While overall imaging growth is in line with or below that of other physician services--2% or less annually since 2006--utilization by nonradiologists continues to outpace that of radiologists significantly.

"Results showed that while a large percentage of PET scans in private offices are done by radiologists, the growth rate among nonradiologists was much higher. Between 2002 and 2007 radiologist-owned Medicare PET scans increased by 259%, whereas nonradiologist owned or leased scans grew by 737%--a significant difference,” noted Dr. Agarwal. "At a time when the costs of imaging and the exposure of patients to radiation are coming under intense scrutiny, it is of great concern that many nonradiologist physicians are going outside the scope of their original specialty training and practice experience by acquiring and leasing advanced imaging equipment such as PET scanners.”

The study was published in the March 2010 issue of the Journal of the American College of Radiology. "Because it has been clearly shown that self-referral leads to higher utilization of imaging this is likely already a significant driver of utilization increases and costs, and it of course also leads to greater exposure of patients to radiation. As was the case with CT and MRI, the PET growth trend among nonradiologists remains high and will bear further watching in future years,” concluded Dr. Agarwal.

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