Concentration on virus-related scans largely sidelines other imaging needs.
Imaging for stroke has declined nearly 40 percent during the COVID-19 pandemic, according to new research, indicating that many cases could go undetected and untreated.
In a research letter published on May 8 in the New England Journal of Medicine, a team led by Akash Kansagra, M.D., from Washington University School of Medicine in St. Louis, examined the number of stroke evaluations in hospitals nationwide. The team's goal was to determine whether stroke care has declined during the outbreak.
With most imaging services pivoting toward patients who either have or are suspected of having COVID-19 infection, it has been difficult to track the care of other conditions, they said. This can be particularly critical for patients who experience a stroke as medical intervention must be performed within 24 hours in order to improve outcomes. And, as recent improvements and interventions in stroke care rely largely on imaging guidance, understanding this impact could potentially improve outcomes and decrease disability.
“The decrease in the use of stroke imaging from the pre-pandemic epoch to the early-pandemic epoch was seen across all age, sex, and stroke severity subgroups,” Kansagra wrote in the letter. “This suggests a decrease in the number of evaluations both in patients with severe strokes and in non-elderly patients who may have been at low risk for COVID-19 complications.”
To reach this conclusion, Kansagra’s team assessed 231,753 stroke evaluations at 856 hospitals across the country. They also measured the number of scans analyzed using the Rapid software from iSchemaView. This tool is frequently used to determine which stroke patients could be good candidates for endovascular therapy based on occlusions of brain arteries or regions that have potentially reversible ischemia because they have not been infarcted.
The team used the Rapid software to determine the number of scans performed each day between July 2019 and April 27, 2020, and they compared it to daily scan numbers during a 29-day pre-pandemic period in February 2020 to a two-week stretch of March 26 to April 8. The number of stroke scans fell to their lowest point during that two-week period, dropping from 1.18 patients per day per hospital before the pandemic to 0.72 patients daily – a 39-percent decline. In addition to declines occurring across age, sex, and stroke severity groups, Kansagra’s team said, the drops also manifested across various states and in hospitals with varying procedure volumes.
These findings, they said, could have a negative impact on patient morbidity if cases aren’t identified and go untreated.
Stay at the forefront of radiology with the Diagnostic Imaging newsletter, delivering the latest news, clinical insights, and imaging advancements for today’s radiologists.
The Reading Room Podcast: A Closer Look at Remote MRI Safety, Part 3
August 5th 2025In the third of a three-part podcast episode, Emanuel Kanal, M.D. and Tobias Gilk, MRSO, MRSE, discuss strategies for maintaining the integrity of time-out procedures and communication with remote MRI scanning.
Twenty Years of CT Colonography for Colorectal Cancer Screening: What the Research Reveals
August 5th 2025Computed tomography colonography (CTC) demonstrated a 91.6 percent positive predictive value (PPV) for polyps > 6 mm, according to new research involving over 9,000 patients who underwent CTC for primary asymptomatic colorectal cancer screening.
The Reading Room Podcast: A Closer Look at Remote MRI Safety, Part 2
August 5th 2025In the second of a multi-part podcast episode, Emanuel Kanal, M.D. and Tobias Gilk, MRSO, MRSE, share their perspectives on remote MRI safety protocols for ensuring screening accuracy and adherence to conditional implant guidelines as well as a rapid and effective response to adverse events.
Chest CT for Post-COVID-19 Abnormalities: Nine Takeaways from a Multi-Society Consensus Statement
August 5th 2025Developed by 21 thoracic radiologists, the new international consensus statement addresses appropriate indications, scan acquisition and keys to reporting for the use of chest CT imaging in evaluating for residual lung abnormalities from COVID-19.
Study Reveals Significant Prevalence of Abnormal PET/MRI and Dual-Energy CT Findings with Long Covid
August 5th 2025In a prospective study involving nearly 100 patients with Long Covid, 57 percent of patients had PET/MRI abnormalities and 90 percent of the cohort had abnormalities on dual-energy CT scans.