Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Imaging Case Volumes

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic has had significant economic impact on radiology with markedly decreased imaging case volumes. The purpose of this study was to quantify the imaging volumes during the COVID-19 pandemic across patient service locations and imaging modality types.

Methods: Imaging case volumes in a large health care system were retrospectively studied, analyzing weekly imaging volumes by patient service locations (emergency department, inpatient, outpatient) and modality types (x-ray, mammography, CT, MRI, ultrasound, interventional radiology, nuclear medicine) in years 2020 and 2019. The data set was split to compare pre-COVID-19 (weeks 1-9) and post-COVID-19 (weeks 10-16) periods. Independent-samples t tests compared the mean weekly volumes in 2020 and 2019.

Results: Total imaging volume in 2020 (weeks 1-16) declined by 12.29% (from 522,645 to 458,438) compared with 2019. Post-COVID-19 (weeks 10-16) revealed a greater decrease (28.10%) in imaging volumes across all patient service locations (range 13.60%-56.59%) and modality types (range 14.22%-58.42%). Total mean weekly volume in 2020 post-COVID-19 (24,383 [95% confidence interval 19,478-29,288]) was statistically reduced (P = .003) compared with 33,913 [95% confidence interval 33,429-34,396] in 2019 across all patient service locations and modality types. The greatest decline in 2020 was seen at week 16 specifically for outpatient imaging (88%) affecting all modality types: mammography (94%), nuclear medicine (85%), MRI (74%), ultrasound (64%), interventional (56%), CT (46%), and x-ray (22%).

Discussion: Because the duration of the COVID-19 pandemic remains uncertain, these results may assist in guiding short- and long-term practice decisions based on the magnitude of imaging volume decline across different patient service locations and specific imaging modality types.

Keywords: COVID-19; imaging volume; modality types; patient service locations.

Fig 1

The 2020 imaging case volume trend across weeks 1 to 16 stratified by patient service locations. The vertical red line at week 10 indicates when the first patient in New York City tested positive for coronavirus disease 2019. Calendar weeks are presented on the x axis and number of imaging examinations on the y axis. ED = emergency department.

Fig 2

The 2020 imaging case volume trend across weeks 1 to 16 stratified by imaging modality types. The vertical red line at week 10 indicates when the first patient in New York City tested positive for coronavirus disease 2019. (A) Imaging volume data for x-ray, CT, and ultrasound (US) examinations. (B) Imaging volume data for interventional radiology (IR), mammography (Mammo), MRI, and nuclear medicine (Nuc Med) examinations. Calendar weeks are presented on the x axis and number of imaging examinations on the y axis.

Fig 3

The trend in the percentage of the 2020 imaging case volumes relative to 2019 across weeks 1 to 16 stratified by patient service locations. The vertical red line at week 10 indicates when the first patient in New York City tested positive for coronavirus disease 2019. Calendar weeks are presented on the x axis and the imaging volume percentage on the y axis. At week 16, the 2020 imaging case volumes represented 54.44%, 95.85%, and 12.45% of the imaging volume in 2019 for the emergency department (ED), inpatient, and outpatient settings, respectively.