Radiology imaging management in an Italian cancer center (IRST IRCCS) during the COVID-19 pandemic

Abstract

In Italy, the first case of the coronavirus disease 2019 (COVID-19) was officially reported on 20.02.2020. The disease has since rapidly evolved, causing a public health emergency throughout the country but especially in our region, one of the most widely affected areas. We reorganized the daily routine of our cancer center to reduce the risk of contagion. A temporary tensile structure was set up as an entry-point triage, and a COVID-19 route was created with a dedicated CT scanner. A pre-access telephonic triage was performed the day before a patient was scheduled to come in for an examination. At the time of writing (May 4), 4053 patients had been to our center since the emergency officially began (9.03.2020) and the COVID-19 route had been activated for only 9 paucisymptomatic outpatients and 7 symptomatic inpatients. We also re-evaluated patient radiology examination lists and rescheduled non-urgent tests in consensus with the referring oncologist. Out of a total of 1438 patients scheduled for radiological examinations, 456 were postponed for a total volume reduction of 29.1%. Nine asymptomatic patients with typical CT findings of COVID-19 were identified during routine CTs, but none were RT-PCR-positive for SARS-CoV-2. We guaranteed all urgent and semi-urgent examinations, including those to stage newly diagnosed cancers and to evaluate response to treatment, ensuring the continuation of the diagnostic and therapeutic pathway of our patients. The measures we took were instrumental in keeping the institute COVID-19-free. We also describe the planned measures to resume normal clinical practice at the center.

Keywords: COVID-19; Health emergency; Imaging management; Radiology imaging.

Fig. 1

The bar chart compares the weekly numbers of patient accesses to the Radiology Unit of our institute for imaging examinations from week 3 to week 18 of 2019 and 2020. Both inpatient and outpatient accesses were considered. A considerable reduction in the number of patient accesses was registered during the lockdown (green bars), which occurred from week 11 to week 18, with respect to the same period in 2019. The decreased access resulted in a reduction in overall radiology activities. N.B. Week 17 of 2019 only had 3 working days because of a national holiday

Fig. 2

The bar chart represents the monthly number of CT examinations performed from January 2019 to May 2020 for the two CTs available in our facility (CT 256 and CT RT). The black dashed line refers to the average data for 2019. The black dashed line represents the rescheduled CTs from the end of February 2020 and during lockdown with respect to the originally planned examinations