By Jennie McKee
Medical imaging plays a vital role in the diagnosis, management and treatment of disease for many patients across the U.S., but the equity of technological access and its potential impact on patient-centered care is an often-overlooked aspect of medical imaging, according to Isabel Montero, MS, a PhD graduate student at Duke University School of Medicine.
Montero conducts research at the Center for Virtual Imaging Trials (CVIT), which is affiliated with the Carl E. Ravin Advanced Imaging Laboratories and the Department of Radiology at Duke University School of Medicine. She presented the results of a study assessing the age of CT scanners across the country and how those ages relate to social vulnerability index (SVI) scores.
“The American Association of Physicists in Medicine (AAPM) recently made improving health equity one of the four priorities of its strategic plan,” Montero said, noting that this was an important motivation for all of the study's investigators, including Ehsan Samei, PhD, the study's senior author. Dr. Samei serves as CVIT director and principal investigator as well as chair of the AAPM Board of Directors.
Montero and colleagues extracted data from the U.S. Food and Drug Administration on the location and year of assembly of approximately 30,000 CT scanners aged 3-28 years throughout the country. They then obtained Minority Health SVI scores for each applicable U.S. county from the Center for Disease Control and Department of Health and Human Services.
They evaluated the associations between CT scanner ages and SVI scores and analyzed CT phantom image data for image quality metrics such as noise magnitude. They then compared those data as a function of scanner age.
The investigators found significant associations between CT scanner age and SVI scores, indicating a possible relationship between social conditions within a county and access to CT technology. For example, data indicate a positive correlation between the age of CT scanners and counties that have higher percentages of people with disabilities, people who are 65 years or older or those in extreme poverty.
The analysis of phantom images found an 8.7 HU increase in noise magnitude in older CT scanner models.
“Most surprising from our findings were the extent of the correlations between social vulnerability metrics—such as poverty, age and minority status—and technological access, especially when comparing non-urban and urban counties,” Montero said.
This study aims to stimulate discourse on mitigating health care inequities to ensure more equitable, patient-centered care for diverse populations, she noted.
“We need conscious efforts in addressing these inequities to ensure consistent diagnostic accuracy and safety, particularly for vulnerable populations,” Montero said. “At the Center for Virtual Imaging Trials at Duke, we are committed to advancing technological innovations and determining how innovations can and should address broader societal needs and priorities.”
Access the presentation, “Disparities of Access to Medical Imaging Technology Across the U.S. as a Function of Social Vulnerability,” (S2-STCE2-2) on demand at RSNA.org/MeetingCentral.
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The RSNA 2024 Daily Bulletin is the official publication of the 110th Scientific Assembly and Annual Meeting of the Radiological Society of North America. Published online Sunday, December 1 — Friday, December 6.
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