Emergency neuroimaging use doubled in US EDs from 2016 to 2025, with CT perfusion multiplying over fivefold

Across >3 million multicenter emergency department encounters, overall ED neuroimaging utilization doubled from 2016 to 2025. Head CT without contrast remained dominant, but CT perfusion use rose >5-fold over the same period, signaling a marked shift in acute stroke workup inten…

• Retrospective multicenter analysis drawing from the Cosmos EHR dataset covering >3 million ED encounters across the United States (2016–2025).
• CT perfusion increased more than fivefold; head CT without contrast remained the most-performed ED neuroimaging examination (exact utilization rates not reported in source).
• Single multicenter EHR dataset may limit generalizability and does not account for varied institutional stroke-alert practices.

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