CT and MR examination volumes have risen across Europe, increasing pressure on imaging capacity, workforce planning and sustainable use of diagnostic resources. European Radiology recently published an assessment of CT and MR utilisation trends in the context of the European Society of Neuroradiology’s Choosing Wisely committee. A PubMed search found no eligible European assessments focused on overall neuroimaging volume, so Eurostat and OECD data were used for 29 European countries. Total CT and MR activity served as a surrogate for neuroimaging because specific data for neurological examinations were not available. The findings cover 2015 to 2022 for scan volumes and a shorter period for scanner availability, with countries grouped into Northern, Southern, Eastern and Western Europe.
Scan Growth Exceeds Equipment Growth
Across the countries assessed, CT and MR examination activity increased substantially over the period. CT examination rates rose by about two-fifths, while MR examination rates rose by a slightly larger proportion. Growth was visible across the continent, although activity dipped in 2020 during COVID-19 disruption. The overall pattern indicates that imaging demand continued to expand despite temporary interruption, with higher per capita activity by the end of the period.
Scanner availability also increased, but equipment growth did not always match the pace of examination growth. CT scanner availability rose more modestly than CT examination volume, suggesting heavier use of existing equipment. MR scanner availability rose more strongly, closer to the increase in MR activity, but regional differences remained. The data therefore point to rising throughput as well as expanded capacity.
This imbalance matters for operational planning. Greater examination volume can affect scheduling, waiting times and reporting workload, particularly when staffing and infrastructure do not expand at the same rate. Radiology workload already carries documented pressure, and rising scan numbers may add to this burden. The results do not show whether increased activity reflects appropriate care or avoidable imaging, but they underline the need to align access, capacity and clinical value.
Regional Patterns Remain Uneven
Western Europe recorded the highest utilisation rates for both CT and MR. Examination volumes increased despite limited growth in CT scanner availability and a small reduction in MR scanner availability. This pattern suggests that higher activity in Western Europe relies heavily on existing capacity and scanner productivity rather than equipment expansion alone.
Northern Europe showed a different profile. CT activity grew more slowly than in other regions, while MR activity increased more clearly. Scanner availability rose for both modalities, with particularly strong growth in MR capacity. Southern Europe recorded marked growth in both CT and MR, with MR examination activity more than doubling. Scanner availability also increased, although at a slower pace than examination volumes.
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Eastern Europe had lower absolute levels of imaging activity but the strongest relative growth. CT and MR examination rates rose sharply, while scanner availability increased more moderately. This combination suggests continuing convergence from a lower baseline, although regional disparities remain. The data do not establish whether differences reflect clinical need, access, administrative systems or healthcare delivery models. European countries have different pathways, service structures and recording practices, which may influence utilisation independently of patient need. UK data were not included in Eurostat and OECD for the period assessed, although available national statistics indicate a broadly similar pattern to other Western European countries.
Appropriateness Becomes More Important
Several factors may contribute to rising neuroimaging demand. Clinical practice increasingly uses advanced imaging in neurological care, including stroke assessment, tumour follow-up and multiple sclerosis monitoring. Ageing populations may also increase demand because central nervous system conditions become more common with age. Technological progress has improved CT and MR speed, accessibility and image quality, supporting earlier and more accurate diagnosis while also making examinations easier to request.
Higher imaging activity can bring clinical value when examinations are appropriate, but it also carries risks and costs. CT contributes to cumulative radiation exposure. Incidental findings may lead to anxiety, further tests and procedure-related complications. Low-value imaging remains a concern when examinations provide little or no benefit. At system level, unnecessary imaging can divert capacity from higher-value care and intensify pressure on already stretched services.
Environmental considerations add another dimension. Radiology contributes to healthcare’s environmental footprint, and neuroradiology accounts for a substantial share of imaging activity. Concerns include energy use, finite resources and contrast media. These factors reinforce the need for practical appropriateness tools. European resources such as ESR iGuide and RCR iRefer already provide imaging recommendations. More harmonised guidance and wider awareness among clinicians outside radiology could help manage demand while preserving access to examinations that improve care.
European CT and MR utilisation increased substantially from 2015 to 2022, while scanner availability grew more unevenly and regional variation persisted. The pattern highlights the need for sustainable neuroimaging practice that balances diagnostic access with capacity, workforce pressure, patient safety and clinical value. Better integrated appropriateness criteria, Europe-specific guidance and monitoring of outcomes could support more consistent use of imaging resources. The central challenge is not simply managing higher scan volumes but ensuring that growth translates into meaningful patient benefit without unnecessary strain on healthcare systems.
Source: European Radiology
Image Credit: iStock
References:
Brosnan C, Rossi A, van der Hoorn A et al. (2026) Choosing wisely in neuroradiology: evaluating CT and MR utilization trends in Europe. Eur Radiol: In Press.
