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Reuse and reduce: abdominal CT, lumbar spine MRI, and a potential 1.2 to 3.4 billion dollars in cost savings

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Abstract

Purpose

To determine how much money could potentially be saved by re-evaluating a patient’s prior recent abdominal CT for lumbar spine pathology instead of ordering a lumbar spine MRI.

Methods

Abdominal CT studies, from all consecutive patients who had an abdominal CT within 12 months prior to a lumbar spine MRI obtained between 11/1/15 and 5/30/16, were retrospectively reviewed in a blinded fashion for the presence of any significant lumbar spine abnormalities. CT studies that accurately reflected all normal and abnormal findings when compared to the standard of reference, the prospectively interpreted lumbar spine MR imaging reports, were used to indicate which lumbar spine MRI studies potentially could have been avoided and to calculate the potential cost savings.

Results

Of the 81 abdominal CT studies that met the inclusion criteria of this study, 62% (50/81) were TP, 28% (23/81) were TN, 5% (4/81) were FP, and 5% (4/81) were FN studies. 90% (73/81) of the lumbar spine MRI studies could potentially have been avoided during the 7 months of this study. The predicted savings by reviewing the abdominal CT for lumbar spine abnormalities prior to ordering a lumbar spine MRI are an estimated 1.2–3.4 billion dollars per year.

Conclusion

Recent abdominal CT studies should be reviewed for lumbar spine pathology prior to a patient undergoing lumbar spine MRI. Avoiding unnecessary lumbar spine MRI studies could potentially save the U.S. healthcare system an estimated 1.2–3.4 billion dollars per year.

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Authors and Affiliations

  1. Milwaukee VA Medical Center, 5000 W. National Avenue, Milwaukee, WI, 53295, USA

    Mitchell A. Klein

Authors
  1. Mitchell A. Klein
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Corresponding author

Correspondence to Mitchell A. Klein.

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Funding

This study received no funding.

Conflict of interest

The authors report no conflicts of interest directly related to this study.

Ethical approval

This retrospective study does not contain any procedures on human participants or animals performed by any of the authors.

Informed consent

The local institutional review board approved this retrospective study and waived the informed consent requirement. This study complied with HIPPAA guidelines.

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Klein, M.A. Reuse and reduce: abdominal CT, lumbar spine MRI, and a potential 1.2 to 3.4 billion dollars in cost savings. Abdom Radiol 42, 2940–2945 (2017). https://doi.org/10.1007/s00261-017-1201-9

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  • DOI: https://doi.org/10.1007/s00261-017-1201-9

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