Abstract

The objective of the present work was to determine current levels and recent nationwide trends in radiological examination frequency, as well as to update corresponding collective effective dose estimates. Examination frequencies were obtained from radiology management systems at all hospitals and private radiology enterprises across Norway in terms of number of examination codes. During the last decade, the overall examination frequency increased by 16% to 910 per 1000 inhabitants, excluding nuclear imaging and dental radiology. The largest increase in examination frequency occurred in MRI (10-fold increase), followed by CT (more than doubling) and mammography (nearly 70% increase). The contribution to collective effective dose from radiological examinations was estimated to 4960 man Sv or 1.09 mSv per inhabitant; representing a 40% increase from 1993 to 2002. CT contribution to collective effective dose was estimated to account for 59% of the total as opposed to 30% in the previous survey.

Highlights

  • I will start this thesis about diagnostic imaging by explaining how fascinating this technology is, and why it is interesting to investigate aspects of its utilization and utility

  • We found a significant increase in utilization of diagnostic imaging, especially Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) examinations, leading to a relatively high increase in the collective effective dose

  • Private institutions accounted for 28% of all examinations, and tended towards performing a higher proportion of single examinations with high variability

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Summary

Introduction

I will start this thesis about diagnostic imaging by explaining how fascinating this technology is, and (despite or perhaps for this reason) why it is interesting to investigate aspects of its utilization and utility. Utilization of high-technology and high-cost diagnostic imaging has increased substantially over the past decades [1,2,3,4,5,6,7] This growth can be attributed to various factors such as aging populations, advances in imaging technology, that radiology is indicated in more clinical conditions [6,8], availability of the technology [9] and increasing number of radiologists [10]. BMC Health Services Research 2009, 9:155 http://www.biomedcentral.com/1472-6963/9/155 tainty and time constraints [15], defensive medicine [16,17], payment system [18], and physicians' self-referral [19,20] The significance of these factors may vary by institutional structures and across countries. Over-utilization is the main concern among the problems of inappropriate utilization [23]

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