Context on COVID-19's Brain Abnormalities, Unique COVID-19 Lung Findings, Breast Imaging News, and Relieving COVID-19 Patients' Imaging Fears

May 22, 2020

Diagnostic Imaging's Weekly Scan: May 22, 2020

Welcome to Diagnostic Imaging’s Weekly Scan. I’m Whitney Palmer, Senior Editor. We’re back with you this week with the latest updates on the COVID-19 outbreak and its impact on the radiology industry.

Last week, the journal Radiology published a study about the brain abnormalities seen with MRI in patients in the intensive care unit who are positive for COVID-19. The research determined that 44 percent of these patients experienced neurological symptoms. However, many in the industry have expressed concerns about the strength of the study and what the findings mean. This week, Diagnostic Imaging talked with Dr. Christopher Hess, distinguished professor and chair of radiology and biomedical imaging at the University of California at San Francisco about how radiologists should view these study results. While the study findings do show a potential association between the virus and the neurological findings, Hess said, the results were not able to show a direct causal link. Ultimately, he said, these outcomes underscore the need to continue to gather data via imaging in order the better understand the impact of the virus.

Throughout the pandemic, diagnostic imaging has been used the monitor and manage COVID-19 progression. However, research published in the Journal of Ultrasound in Medicine showed that contrast-enhanced lung ultrasound reveals patterns in the lung that are not typically associated with viral pneumonia. Citing three male patients positive for COVID-19 who exhibited symptoms of pneumonia in Italy, investigators found large perfusion defects in a pattern not usually seen with pneumonia or lung collapse. They conducted X-rays and ultrasounds and found abnormal early arterial enhancement, incomplete enhancement of major consolidations, sharp boundaries between perfused and nonperfused areas, and no enhancement of consolidations less than 2 cm. The researchers said physicians can use contrast-enhanced ultrasound to help guide treatment plans with patients who are COVID-19-positive.

As you have no doubt experienced, a drop in revenue has accompanied the reduction in imaging volume that has been seen throughout the pandemic. There are ways for you to begin to recoup that money, however. Dhruv Chopra, chief executive officer of radiologist-owned alliance Collaborative Imaging outlined three strategies to help you recapture revenue, including how to enhance your revenue cycle, ways to identify gaps in your current billing service, and methods for using automated workflow solutions to prepare for spikes in business.

News this week also emerged about follow-up care with mammography and breast cancer. Although it has been standard procedure to conduct follow-up imaging after six months on women who have a BI-RADS 3 score, the protocol has been debated within the specialty. In research published this week in Radiology, investigators from the University of Pittsburgh Medical Center Magee-Womens Hospital analyzed the medical records of nearly 44,000 women who had six-month, 12-month-, and 24-month follow-up imaging who received a BI-RADS 3 assessment. According to their results, nearly 2 percent of women were diagnosed with a new breast cancer during follow-up. Roughly 58 percent of those cancers were identified at or before the six-month mark, and 12 percent of those cases were diagnosed as invasive cancers.

In other breast imaging news, the conversation continues about the role, benefits, and challenges of abbreviated breast MRI. While the service has been found to be equally accurate, take less time, and cost less, clinical implementation has been slow to take off. In an article published in the Journal of Breast Imaging, researchers from NYU Langone Health discussed the benefits and challenges of using abbreviated MRI, as well as outlined the strategies and methods practices and imaging centers can use to more easily integrate it into the services they provide to patients.

Amid all the studies and clinical evidence that continues to emerge about COVID-19, a Medscape survey published this week revealed good news for the radiology industry overall. According to feedback from more than 17,000 physicians, including approximately 500 radiologists, radiology ranks among the top five highest-paid and happiest specialties. Compared to the previous year, radiology experienced a 2-percent income increase, raising the annual salary to roughly $427,000. This is compared to an average yearly salary of $346,000 for other specialties and $243,000 for primary care physicians. Those who compiled the survey did acknowledge this data was collected prior to the pandemic, indicating the outbreak has led to a loss of 43,000 healthcare jobs, a 60-percent drop in patient volume, and a roughly 55-percent dip in revenue. Still, radiologists overwhelmingly reported – at 93 percent -- that, if given the chance, they would choose the specialty all over again.

And, finally, this week Diagnostic Imaging turned its focus to the patients you see who are affected by COVID-19. For many who experience symptoms and need some form of diagnostic imaging, it will be the first time they’ve had a chest X-ray or CT scan. And, the experience can be frightening. Making those patients feel comfortable and calm can be critical to capturing images of high quality and high diagnostic value. To shed light on how to put your patients at ease, Diagnostic Imaging spoke with Randi Homan, multi-modalities supervisor at Novant Health Huntersville Medical Center in North Carolina about the strategies she and her staff use to educate patients about what to expect with a scan, as well as allay any fears they might have about the process. Here’s what she had to say.