CT imaging procedures have reached an all-time high in the United States, reaching an estimated 91.4 million in 2019, which is up 3% from 88.7 million CT procedures in 2018, according to IMV Medical Information Division’s newly published 2019 CT Market Outlook Report.

This increase in total CT procedures is mirrored in the sentiment expressed by the respondents to IMV’s survey, where 79% of the CT sites indicated their 2019 CT patient volume increased over their 2018 volume, which is a 12-point increase from 67% of the respondents in IMV’s 2016 survey indicating patient volume increases.

This annual increase appears to have reversed a nationwide slowdown in CT procedure growth.  Prior to 2018, total CT procedures had been down from a prior peak in 2011, when 85.3 million CT procedures were performed.  CT procedures had been rising at a 12% average annual growth rate from 2001 to 2011, but then declined 5% to 80.6 million in 2012.  This apparent slowdown in total CT procedures starting in 2012 may have been influenced by the following factors:

  • A change in reimbursement policy from the Centers for Medicare & Medicaid Services (CMS) which bundled certain procedures together for reimbursement purposes, such as abdomen & pelvis. Some CT departments may not necessarily have experienced a drop in the actual patient scanned although the number of CPT-4 codes they could utilize for billing purposes was reduced.
  • The growing usage of “Appropriate Use” criteria in ordering CT procedures, which were further reinforced by a change in reporting policy from the CMS, mandating that under the PAMA (Protecting Access to Medicare Act of 2014), physicians are to utilize a clinical decision support system for ordering imaging studies (CT, MR, PET, and NM only) to assure appropriate use of imaging resources and to minimize over-utilization.

However, despite these reimbursement policies, CT scanners have become an essential diagnostic tool, resulting in the recent procedure increases, particularly for emergency scans.  In hospitals, about half of the CT procedures are being conducted on an emergency basis, and an additional 30% are being performed on outpatients.  This increased load on CT departments to perform unscheduled CT scans in addition to their routine workload has influenced CT departments to place a high priority on improving CT department workflow and productivity, improving staff satisfaction and morale, and on managing their increased CT volume.  One hospital respondent stated one impact on managing their CT operations: “Our emergency department is so busy that we have had to scale back our routine outpatients due to ER and inpatient loads.”

The larger 400+ bed hospitals, in particular, are meeting this workflow challenge by placing CT scanners directly in or near emergency departments, in addition to those installed in their main radiology department.  Over half of the 400+ bed hospitals have at least one of their CT scanners located in their emergency department.

While the majority of the respondents share optimism that their procedures will grow due to the increasing utility of CT imaging, over two thirds feel that their “current CT scanner technology meets their clinical and throughput needs” and that their “current CT capacity is sufficient to meet anticipate patient volumes over the next 2-3 years,” which may impact near-term market growth for purchasing CT scanners.

Regarding their plans for acquiring CT scanners over the next three years, replacements are driving CT purchases, with about 80% of the planned CT purchases replacing older units.  Survey results indicate a relatively stable CT market, with 28% of all CT sites “Yes, planning” to purchase a CT scanner over the next three years plus an additional 23% that are “Maybe planning.”  While those who “Maybe” plan to purchase CT scanners represent a less certain market potential for CT, the combined total for the sites “Yes” and “Maybe” planning has been relatively consistent at 51-58% since IMV’s 2012 report.

For the CT sites that are in the buying mode, over 80% of the planned CT scanners will have configurations with 64 or more slices, and the facilities are seeking advances in CT hardware and software technology to provide high quality images while reducing the need for using contrast media, to lower radiation dose, to scan obese patients, and to decrease scan time.  The CT respondents are also seeking improved information technology capabilities to address CMS’ requirements to implement Appropriate Use Criteria via electronic decision support systems, to integrate cumulative radiation and contrast dose tracking into their workflow, and to increase cybersecurity.

The CT respondents feel that the use of artificial intelligence (AI) and machine learning tools in their environment is still in its early adoption state, with only 18% of the respondents giving high “4-5” ratings (on a rating scale of 1-5) for the outlook factor “we will be early adopters for artificial intelligence applications using CT data for clinical decision support.”  However, the respondents are hopeful that AI will help them with their department priorities, with the two top-ranked potential uses for artificial intelligence applications being “capabilities to improve image quality output” and “tools to help workflow from image acquisition to providing images to the radiologists.”


Lorna Young is senior director of market research at IMV Medical Information Division, part of Science and Medicine Group.

IMV’s 2019 CT Market Outlook Report explores market trends in U.S. hospitals and imaging centers, including procedure volume, manufacturer installed base features and share, the use of OEM vs. third-party service providers, purchase plans, brand loyalty, contrast utilization/budgets, CT power injectors, and site operations characteristics. The report is based on responses from 402 radiology/CT administrators who participated in IMV’s nationwide survey in August-September 2019. Their responses have been projected to the IMV-identified universe of hospitals and imaging centers in the U.S. that use fixed CT scanners, and the report provides market forecast scenarios addressing the CT unit market in the United States for 2019-2023.  Vendors covered in this report include Bayer/Medrad, Bracco Imaging, Canon/Toshiba Medical Systems, GE Healthcare, Guerbet, Hitachi Healthcare, Neusoft, Philips Healthcare, Samsung Healthcare, Siemens Healthineers, and United Imaging.

For information about purchasing IMV’s 2019 CT Market Outlook Report, visit the corporate website at http://www.imvinfo.com or call 703-778-3080 ext. 1033 to speak with a representative.