By Mahmud Mossa-Basha, M.D.
Radiology has played an integral role in the diagnosis and management of patients with COVID-19. While the reverse transcriptase-polymerase chain reaction test (RT-PCR) is the primary test for diagnosis because of its high specificity, imaging plays a role in the evaluation of cases with atypical presentations and cases for which there is suspicion of alternative diagnoses that would alter management. In addition, in locations where RT-PCR testing is limited or turnaround time is significantly prolonged, imaging, specifically CT, can help with early screening. In terms of patient management, CT imaging can be used to further evaluate patients with COVID-19 when they decompensate.
Radiology departments have had to develop policies and guidelines to create appropriate precautions for imaging patients with COVID-19 to ensure efficient patient imaging for prompt diagnosis, while appropriately protecting staff, faculty, other patients, and the community from COVID-19 exposure. Important precautions for preventing patient-to-patient and patient-to-healthcare worker dissemination must be taken. These precautions include appropriate use of personal protective equipment (while also considering conservation) and appropriate room cleaning and air clearance. In addition, postponement or cancellation of elective procedures and imaging to free up resources and prevent additional exposures is necessary.
The COVID-19 pandemic has had a substantial impact on operations for radiology departments and practices across the country. The postponement and cancellation of elective imaging and procedures has significantly affected radiology department finances. Department leadership has been pushed to find ways to cut costs in the short term for practices to remain solvent. Academic and private practices have taken very different approaches to this situation. Actions have included furloughing of faculty and staff, deferring incentive-based payments for employees, eliminating extra pay for excess shifts, and in severe cases, laying off radiology department employees.
Post-COVID imaging is expected to surge, due to all the cases that were postponed, and radiology departments need to be prepared for the expected high volumes. Imaging resources will need to be accessible for extended hours on weekdays and on weekends for outpatient imaging. Upstaffing of technologists and radiologists during this period will also be necessary to manage the volumes.
Dr. Mahmud Mossa-Basha is a neuroradiologist and associate professor at the University of Washington School of Medicine. He serves as vice chair of clinical operations and the radiology chief of service at University of Washington’s Montlake and Northwest campuses. He is also the director of MRI. His clinical and research interests include workflow optimization and increased system efficiencies, as well as stroke and spinal cord injury imaging.