CHICAGO - Unlike other imaging areas where American radiologists appear to be losing ground to other specialists, recent data on procedural volumes show that vascular ultrasound has been a "win" for radiology.
That's according to radiologist Dr. David Levin, of the Center for Research on Utilization of Imaging Services at Thomas Jefferson University in Philadelphia, who presented his center's data on vascular ultrasound volumes on Monday afternoon at the RSNA meeting.
Levin described the vascular ultrasound data as "a rather pleasant surprise," drawing an implicit comparison to other studies his group has done that show radiologists with a diminishing share of imaging volume.
The researchers analyzed vascular US performance by looking at Medicare's physician fee-for-service database from 1998 to 2003. Medicare patients receive about one-third of all imaging studies performed in the U.S., Levin noted.
Claims data for 15 vascular ultrasound CPT codes in the 93000 series were reviewed. The exams included ones performed on the neck and cranial arteries, extremity arteries and veins, and other areas.
Overall, the volume of vascular ultrasound increased by 35% over the study period, from 116 studies per 1,000 Medicare beneficiaries to 157 per 1,000.
Cardiologists increased their volume by 66% over the five-year period, nearly twice the pace of radiologists and vascular surgeons. But cardiologists' volume growth rate didn't overcome the overall share advantage held by radiologists.
As of 2003, radiologists performed 42% of all vascular US procedures, surgeons 26%, and cardiologists 13%, with other physicians rounding out the rest.
Radiologists also added 900,000 new vascular US procedures over the five-year period. Overall, the trend lines for the specialties performing vascular US were increasing in parallel, Levin noted.
"Nobody is acquiring a lot of the business of other specialties," he concluded.
By Tracie L. Thompson
AuntMinnie.com staff writer
November 29, 2005
Copyright © 2005 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
