HealthDay News — In a multinational consensus statement from the Fleischner Society, published online April 7 in Radiology, recommendations are presented for use of imaging in patients with coronavirus disease 2019 (COVID-19).
Geoffrey D. Rubin, MD, from the Duke University School of Medicine in Durham, North Carolina, and colleagues examined the utility of chest radiography (CXR) and computed tomography (CT) imaging within 3 scenarios representing varying risk factors, community conditions, and resource constraints. Fourteen key questions were rated by a multidisciplinary panel; the results were aggregated, yielding 5 main recommendations and three additional recommendations.
According to the statement, for asymptomatic individuals, imaging is not routinely indicated as a screening test; in addition, imaging is not recommended for patients with mild features of COVID-19 unless they are at risk for progression of disease. For patients with moderate-to-severe features of COVID-19, imaging is indicated, regardless of COVID-19 test results. For patients with COVID-19 and evidence of worsening respiratory status, imaging is indicated. CXR may be preferred for patients with COVID-19 in a resource-constrained environment, unless features of respiratory worsening warrant CT use. In stable intubated patients with COVID-19, daily chest radiographs are not indicated. In patients with functional impairment and/or hypoxemia after recovery from COVID-19, CT is indicated. In patients incidentally found to have signs suggestive of COVID-19 on a CT scan, COVID-19 testing is indicated.
“As effective treatments are developed, thoracic imaging may find new roles by establishing treatment response or characterizing patients as likely responders to novel therapies,” Rubin said in a statement.