Format

Send to

Choose Destination
J Urol. 2018 Jul;200(1):89-94. doi: 10.1016/j.juro.2018.01.071. Epub 2018 Feb 2.

Evolving Use of Prebiopsy Prostate Magnetic Resonance Imaging in the Medicare Population.

Author information

1
Department of Radiology, New York University Langone Medical Center, New York, New York. Electronic address: Andrew.Rosenkrantz@nyumc.org.
2
Harvey L. Neiman Health Policy Institute, Reston, Virginia.
3
Harvey L. Neiman Health Policy Institute, Reston, Virginia; School of Economics, Georgia Institute of Technology, Atlanta, Georgia.
4
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
5
Department of Radiology, Grandview Medical Center, Birmingham, Alabama.
6
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.

Abstract

PURPOSE:

We assessed the changing use of prebiopsy prostate magnetic resonance imaging in Medicare beneficiaries.

MATERIALS AND METHODS:

Men who underwent prostate biopsy were identified in 5% Medicare RIFs (Research Identifiable Files) from October 2010 through September 2015. We evaluated the rate of prebiopsy prostate magnetic resonance imaging, defined as any pelvic MRI 6 months or less before biopsy with a prostate indication diagnosis code. Temporal changes were determined as well as variation by geography and among populations.

RESULTS:

In male Medicare beneficiaries the prebiopsy magnetic resonance imaging use rate increased from 0.1% in 2010 to 0.7% in 2011, to 1.2% in 2012, to 2.9% in 2013, to 4.7% in 2014 and to 10.3% in 2015. In 2015 the prebiopsy prostate magnetic resonance imaging rate varied significantly by patient age, including 5.7% for greater than 80 years vs 8.4% to 9.3% for other age ranges (p = 0.040) as well as by race, including 5.8% in African American vs 10.1% in Caucasian men (p = 0.009) and geographic region, including 6.3% in the Midwest to 12.5% in the Northeast (p <0.001). The rate was highest in Wyoming at 25.0%, New York at 23.7% and Minnesota at 20.5% but it was less than 1% in 10 states.

CONCLUSIONS:

Historical Medicare claims provide novel insights into the dramatically increasing adoption of magnetic resonance imaging prior to prostate biopsy. Following earlier minimal use the performance increased sharply beginning in 2013, exceeding 10% in 2015. However, substantial racial and geographic variation exists in adoption. Continued educational, research and policy efforts are warranted to optimize the role of prebiopsy magnetic resonance imaging and minimize sociodemographic and geographic disparities.

KEYWORDS:

Medicare; biopsy; diagnostic imaging; magnetic resonance imaging; prostatic neoplasms

PMID:
29410202
DOI:
10.1016/j.juro.2018.01.071

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center