Although internal medicine specialists have long been the primary providers of bone marrow biopsies, their market share for the procedure has declined -- and radiology is picking up the slack, according to a study published online March 3 in the Journal of the American College of Radiology.
"Radiology has experienced the greatest rate of growth [as a provider of bone marrow biopsies] and now represents the third largest individual specialty providing this service," wrote a team led by Dr. Osman Ahmed of the University of Chicago Medical Center.
Studies have shown an overall trend toward the increased use of image-guided procedures, but little research exists that describes where bone marrow biopsies fit into this pattern. Ahmed and colleagues sought to investigate bone marrow biopsy procedures by specialty and practice setting, using information from the U.S. Centers for Medicare and Medicaid Services (CMS) Medicare Physician Supplier Procedure Summary database between 2005 and 2016. The group categorized the data according to the four largest subspecialty groups (internal medicine, surgery, radiology, and pathology) and procedure setting (office, inpatient hospital, and outpatient hospital).
In the study time period, physicians performed an annual average of 11,417 bone marrow biopsies, with no significant change in volume from year-to-year. But who provided the procedure changed over time: Radiology grew from 4.1% in 2005 to 16.2% in 2016, for a compound annual growth rate (CAGR) of 12.43%, while internal medicine decreased from 60.2% in 2005 to 36.6% in 2016, for a CAGR of -5.16%.
The group also found that bone marrow biopsy procedures shifted from office settings to the hospital over the course of the study timeframe, regardless of physician specialty.
The study results suggest that radiologists may play an even more important role in providing bone marrow biopsies to patients in the future, according to the authors.
"Given the potential safety with the use of image guidance and patient comfort under moderate sedation, radiology may continue to increase market share in the future," they concluded.
![Representative example of a 16-year-old male patient with underlying X-linked adrenoleukodystrophy. (A, B) Paired anteroposterior (AP) chest radiograph and dual-energy x-ray absorptiometry (DXA) report shows lumbar spine (L1 through L4) areal bone mineral density (BMD). The DXA report was reformatted for anonymization and improved readability. The patient had low BMD (Z score ≤ −2.0). (C) Model (chest radiography [CXR]–BMD) output shows the predicted raw BMD and Z score in comparison with the DXA reference standard, together with interpretability analyses using Shapley additive explanations (SHAP) and gradient-weighted class activation maps. The patient was classified as having low BMD, consistent with the reference standard. AM = age-matched, DEXA = dual-energy x-ray absorptiometry, RM2 = room 2, SNUH = Seoul National University Hospital, YA = young adult.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/04/ai-children-bone-density.0snnf2EJjr.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Representative example of a 16-year-old male patient with underlying X-linked adrenoleukodystrophy. (A, B) Paired anteroposterior (AP) chest radiograph and dual-energy x-ray absorptiometry (DXA) report shows lumbar spine (L1 through L4) areal bone mineral density (BMD). The DXA report was reformatted for anonymization and improved readability. The patient had low BMD (Z score ≤ −2.0). (C) Model (chest radiography [CXR]–BMD) output shows the predicted raw BMD and Z score in comparison with the DXA reference standard, together with interpretability analyses using Shapley additive explanations (SHAP) and gradient-weighted class activation maps. The patient was classified as having low BMD, consistent with the reference standard. AM = age-matched, DEXA = dual-energy x-ray absorptiometry, RM2 = room 2, SNUH = Seoul National University Hospital, YA = young adult.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/04/ai-children-bone-density.0snnf2EJjr.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
