Radiology volumes post-pandemic: An analysis of 12.4 million imaging examinations from 197 radiology facilities

Purpose: To determine changes in site- and radiologist-specific imaging volumes before, during and after the COVID-19 pandemic from a large, diverse sample of U.S. radiology practices.

Methods/Materials: Imaging volumes (43.2 million examinations) for 1,600 unique radiologists and 197 U.S. radiology practices in 23 states (academic [N<=5], community hospital [N=79], multi-specialty clinic [N<=5], freestanding imaging center [N=109], other [N<=5]) participating in the American College of Radiology General Radiography Improvement Database (GRID) from Dec. 1, 2017 to Feb. 28, 2023 were analyzed. These dates were chosen to include baseline, pandemic, and post-pandemic periods. Six modalities were analyzed individually and in aggregate: computed tomography (CT), mammography, magnetic resonance imaging (MRI), X-ray, ultrasound, and positron emission tomography (PET)-CT. National Provider Identifiers (NPIs) were used to track individual radiologists. Changes in workforce number (by NPI), workload (exams/day), NPI attrition, and NPI turnover were calculated by quarter.

Results: Of the 1,600 radiologists in the sample, only 804 (50%) were present for the entire study period, and only 581 (36%) read at least 100 examinations in an included practice in every quarter. Mean changes in exams read/day from 2017 to 2023 were modest: +1.4% (49.5/day to 50.9/day) to -0.2% (54/day to 53.8/day), respectively, showing complete recovery following a peak decline of -35%/quarter (2,015,150 to 1,304,748) March-May 2020. However, the top quartile radiologists by volume experienced dramatic increases in exams/day (+25.4%; 52.3/day baseline vs. 65.6/day in 2022) and clinical days worked/quarter (+24.4%; 37.7 vs. 46.9, respectively) from 2017 to 2022. Although there was substantial turnover, the number of unique radiologists in the sample increased from 997 (baseline) to 1,144 (2023), and days worked/NPI/quarter remained similar (40 days vs. 39 days).

Conclusions: There has been complete recovery of radiology imaging volume since the pandemic. Although the average radiologist reads a similar number of examinations/day pre- vs post-pandemic, high-volume radiologists now read 25% more examinations/day and work 24% more clinical shifts/quarter.