75% of CT Scan, 80% of MRI Requests Deemed Medically Relevant in 2023

On Tuesday 19 September 2023, Luxembourg's Ministry of Health announced the publication of the second national audit on the medical relevance of requests for CT scans and MRI examinations on sante.lu.

This audit, carried out by four external auditors (all radiology professors in France), assessed the relevance of 600 requests for CT (X-ray) scans and 480 requests for MRI examinations.

The methodology used in this audit is based on that of the first one carried out in 2016. Each radiology department with CT or MRI equipment provided 60 CT requests and 60 MRI requests (all anonymised) for examinations that had already been carried out.

The auditor evaluations found that requests for CT scans and MRI examinations in 2023 included significantly more information on the clinical context and the purpose of the requested examination than in 2016.

In addition, the relevance rate for CT scan requests increased from 61% in 2016 to 75% in 2023. That of requests for MRI examinations remained stable, reaching 80% in 2023 (compared to 78% in 2016). Requests for CT scans of the spine and extremities had the lowest relevance rates (46% and 68%), similar to 2016.

Moreover, the percentage of requests for irrelevant CT scans, for which no alternative examination was indicated, decreased significantly, from 16% in 2016 to 3% in 2023.

The audit also concluded that another type of examination would have been better indicated for 22% of CT scan requests and for 14% of MRI examination requests.

The relevance rate for CT (94%) and MRI (93%) requests concerning children was deemed much better than for requests concerning adults - another similar finding as in 2016.

The Ministry of Health noted that the relevance of requests for CT scans carried out by radiology services, as well as the content of requests by requesting doctors, have seen a significant improvement compared to the first audit carried out in 2016. This improvement can be attributed to different initiatives, such as the addition of five additional MRI machines to the existing seven in 2016, awareness campaigns among the public and doctors, legal changes regarding the justification of radiological examinations in 2019, as well as the creation of guides, application forms and training courses to support these changes. In addition, radiation protection inspections were carried out in all radiology departments, noted the ministry.

Luxembourg's Deputy Prime Minister and Minister of Health, Paulette Lenert, commented: "We remain committed to continuing to promote the relevance of CT and MRI examinations to ensure quality care and optimal use of these medical technologies in the Grand Duchy of Luxembourg."