COVID-19 and the Radiology Department: What We Know So Far

Abstract

COVID-19 is a global healthcare pandemic that is now growing through nations across the world. The role of radiology is crucial, and a variety of guidelines have been published regarding the role of imaging. These aim to protect healthcare workers (HCWs) and the general public from exposure, while preserving critical radiology operations and conserving personal protective equipment (PPE) and other critical care resources during the COVID-19 pandemic. Fleischner Society published guidelines on indications of imaging various settings. These guidelines take into account resource availability, pre-test probability, degree of symptoms and risk factors, which is crucial for decision-making regarding need and indications of imaging. Mitigating steps and alternative approaches should be considered to provide the best care for patients while protecting all HCWs. Owing to overlap of COVID-19 imaging findings with other pathologies, standardized reporting acquires importance for risk assessment and effective communication of suspicious findings. RSNA followed by Dutch Radiological Society (NVvR) have published guidelines on standardized CT reporting for COVID-19, which show excellent inter-observer variability. Standardized reporting can provide guidance and confidence to radiologists as well as increased clarity to physicians through reduced reporting variability. The article discusses the published recommendations and aims to make radiologists aware of the protocols and guidelines that need to be followed in this ongoing public health crisis for effective patient care while protecting HCWs and conserving resources.

Keywords: COVID-19; Coronavirus; Imaging; Pandemics; Radiology.

Fig. 1

Illustrated image depicting CT findings of CO-RADS 1. The single asterisk (*) indicates emphysema; the single number sign (#) represents perifissural nodules; the double asterisk (**) represents fibrosis; the double number sign (##) indicates lung carcinoma

Fig. 2

Illustrated image depicting CT findings of CO-RADS 2. The single asterisk (*) indicates lung abscess; the single number sign (#) indicates lobar consolidation; the double asterisk (**) indicates bronchitis; the double number sign (##) indicates centrilobular nodules

Fig. 3

Illustrated image depicting CT findings of CO-RADS 3. Ground-glass opacities in a homogeneous extensive (number sign) or perihilar (double asterisk) distribution with smooth interstitial thickening

Fig. 4

Illustrated image depicting CT findings of CO-RADS 4. Ground-glass opacities in a unilateral peribronchovascular (asterisk) distribution

Fig. 5

Illustrated image depicting CT findings of CO-RADS 5. Ground-glass opacities in a multifocal bilateral (asterisk) distribution