Diagnostic Imaging's Weekly Scan: Aug. 21, 2020

August 21, 2020

CT and heart attack prediction; lagging outpatient imaging volume recovery; equivalent thoracic MRI performance with COVID-19 pneumonia; and CT colonography during COVID-19

Welcome to Diagnostic Imaging’s Weekly Scan. I’m Whitney Palmer, senior editor.

Before we get to our featured interview this week about the benefits of using CT colonography for colon cancer screening during the pandemic, here are the most popular stories of the week.

The predictive value of CT scans received a nod this week in an article published in the journal Circulation: Cardiovascular Imaging. Researchers from the University of Texas Southwestern Medical Center determined that CT scans of the calcified plaque that collects in the arteries – coronary artery calcium or CAC – can more accurately predict whether a patient will have a heart attack within 10 years versus a stroke. By examining CT scans from 7,024 patients, the team found that patients with CAC scores at or above 100 were at a two-fold greater risk for heart attack than stroke. And, this held true across gender and race, equally affecting black, white, and Hispanic men and women. The team said these results could help providers decide how aggressively to treat patients who have never had a major cardiac event, but who also have other risk factors, such as high blood pressure or high cholesterol.

Even though radiology overall is well into figuring out how to bounce back from the impacts the pandemic has had on its levels of imaging volume, not everyone in the industry is being equally successful. Outpatient imaging centers – which, according to industry analyses experienced the most significant drops in volume – are still lagging behind hospitals in their recovery. In a study published in Academic Radiology, a team from Massachusetts General Hospital and Harvard Medical School assessed the fluctuations in imaging volumes between the main hospital and 26 affiliated outpatient centers. They found during the early stages of the pandemic while the hospital saw a 54 percent drop in weekly imaging volumes, the outpatient centers experienced a 64-percent reduction. And, while more patients are returning for imaging now, the rise in volume is still uneven – the hospital has recovered 70 percent of its volume, but the imaging centers are pacing slightly behind with 66 percent. There could be several reasons for this, they said. Patients and referring providers could still be postponing elective imaging, some affiliated imaging centers may be slower in re-opening, or perhaps these postponed studies have led to higher-acuity visits that must be handled at the main hospital. The team said they hoped this and future studies could play a role in creating generalizable prediction and economic recovery models that support budgetary and resource allocation decisions during future times of crisis.

But, reclaiming those pre-pandemic imaging volume levels is possible, according to a team from the University of Cincinnati. You just have to “Recover Wisely,” they said. And, they shared their experience in an article in Academic Radiology. To reach their pre-pandemic volume within 10 weeks, they assembled a task force that included administrators, radiologists, technologists, and schedulers and began tackling their imaging backlogs in early May. They collected imaging data by date, time-of-service, site-of-service, modality, and scanner used. With this information, they prioritized their patient list and scheduling and began planning for re-opening some facilities. By the end of the 10 weeks, they had recovered 102 percent of their overall outpatient imaging volume.

As the pandemic lingers on, radiology researchers are still trying to identify the best ways support the patient management and diagnosis needs. One team of investigators from Sakarya University in Turkey shared their findings in an article published this week in Academic Radiology. They found thoracic MRI performs equivalently to thoracic CT when imaging for COVID-19 pneumonia, limiting their radiation exposure. To make this determination, they examined both CT and MRI studies from 32 patients who were positive for COVID-19 pneumonia. Based on their findings and using the CT scans as a reference, the team calculated MRI’s sensitivity at 91.7 percent, specificity at 100 percent, positive predictive value at 100 percent, and negative predictive value at 95.2 percent.

And, lastly this week, Diagnostic Imaging spoke with Dr. Courtney Moreno, associate professor of radiology and imaging sciences at the Winship Cancer Institute at Emory University School of Medicine about the benefits of using CT colonography during the COVID-19 pandemic. This non-invasive imaging test not only offers more information for colon cancer screening, but it also facilitates better social distancing and less use of personal protective equipment – both factors that are critically important in the healthcare environment. Here’s what Dr. Moreno had to say about the advantages of this test.