Diagnostic Imaging's Weekly Scan: May 29, 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.
Existing guidance from the American College of Radiology released at the beginning of the pandemic has already cautioned providers and referring clinicians from using chest CT scans for identifying patients who are positive for COVID-19 infection. Research published this week in the American Journal of Roentgenology underscored that recommendation. In a study from Icahn School of Medicine at Mount Sinai, investigators examined chest CT scans from 30 children between the ages of 10 months and 18 years who were treated at six hospitals in China from mid-January to early-February of this year. Based on their analysis, the team determined that 77 percent of chest CT scans conducted on pediatric patients positive for the virus were negative for any viral findings. Follow-up imaging showed no change in the scans. Among the seven patients with positive chest CT scans, six had ground-glass opacities, and one had both ground-glass opacities and consolidation. In addition, lower lobes were most commonly involved. Ultimately, the team explained, the low sensitivity of the chest CT scans coupled with the fact that these findings are not specific to COVID-19 should make radiologists and other providers pause before ordering the exam.
Throughout the pandemic, advice and guidance on how to best protect and disinfect CT scanners, X-ray machines, and ultrasound probes has circulated through the industry. But, there are also steps that MRI suites can take to maximize decontamination efforts and safety measures to protect both patients and staff. Alongside the recommended six to 12 hourly air changes, researchers from the University of Southern California Keck School of Medicine and the University of California at Los Angeles David Geffen School of Medicine recommended, in a Journal of the American College of Radiology article, six additional steps for the MRI suite. Wipe down the bay and patient-contact surfaces with approved disinfectant wipes after every patient. Add another one hour of downtime after scanning patients with suspected or confirmed COVID-19 infection. Close all MRI waiting areas to decrease the risk of airborne viral transmission. Have all staff adhere to personal protection equipment (PPE) protocols at all times. Replace PPE after scanning patients with suspected or confirmed COVID-19 infection, and be sure all the PPE that will be used in the magnet room is MRI-safe.
It might sound a little strange, but a plastic bag could prove highly effective in reducing the risk of COVID-19 transmission with patients who undergo chest CT scans. Investigators from the National Institutes of Health unveiled their prototype for a patient isolation bag in Academic Radiology. This hypoallergenic plastic polymer bag is made from the same material that protects ultrasound transducers, CT gantries, and image detectors. Staff help patients put the suit on, rolling it down from their head. The bag seals around the patient’s head and chest with either an elastic band or disposable Velcro belt. The patient breathes through an air intake nozzle that has a nasal cannula for patients who need additional oxygen. According to the researchers, the bag could reduce the two-hour decontamination and ventilation time, increasing the number of patients scanned daily from 10 to 144 patients.
Early estimates of how COVID-19 would impact imaging volumes predicted that practices, departments, and imaging centers would see up to a 70-percent drop in the number of scans requested. New research from Northwell Health and the Neiman Health Policy Institute published this week in the Journal of the American College of Radiology, however, revealed that, while the amount isn’t that large, the dip in volume is still significant. Based on a review of the same 16-week period from 2019 and 2020, investigators determined the industry has seen an overall 28-percent decline in total imaging volume. For the same time period, radiologists conducted 522,645 scans in 2019 compared to 458,438 in 2020. More specifically, the data showed a nearly 55-percent drop in emergency room imaging volumes, a 37-percent decline in inpatient imaging, and a nearly 88 percent reduction in imaging in the outpatient setting. The biggest decline was seen in mammography, followed by nuclear medicine, MRI, ultrasound, interventional radiology, CT, and X-ray.
And, finally, this week, there has been news, looking at the impact of the COVID-19 pandemic on female radiologists and how their experiences have differed from those of their male counterparts. The challenges can be both professional and personal, spanning from having less time to publish academic articles to needing to devote energies to caring for loved ones. To discuss these differences and what they mean for providers and the industry overall, Diagnostic Imaging spoke with Dr. Geraldine McGinty, president of the American College of Radiology. She discussed what the industry has seen develop as this outbreak has continued. Here’s what she had to say.