The ACR Encourages Limiting CT and CXR for COVID-19 Patients

The American College of Radiology (ACR) is urging radiologists to steer clear of CT scans and chest radiographs (CXR) as their first line of diagnostic defense of COVID-19 diagnosis and treatment, according to a recently issued statement.

With the unpredictability of available testing kits and early reports of test sensitivity from China, health care providers are turning to imaging devices to detect infection symptoms. However, the ACR encourages healthcare providers to stick to viral testing, and explains why CT and CXR should be used at a minimum. Here are some takeaways from the official recommendation:

• The results from chest images of potential COVID-19 patients share similarities with other conditions, such as influenza, H1N1, SARS, and MERS. Since the pandemic coincides with flu season, it can be easy to confuse respiratory symptoms.
• In a study utilizing randomized trials, the Cochrane Database of Systematic Reviews evaluated the use of CXRs in both child and adult patients with acute respiratory tract infections and found that CXR didn’t speed up recovery time.
  
• Cleaning and decontamination of clinical spaces occupied by COVID-19 patients is absolutely critical, and by the same token, x-ray rooms where infected patients have been imaged need to be cleaned with the same due diligence. Ventilation is a main culprit in the transmission of illnesses in health care facilities, and in many cases, imaging rooms should be empty for around one hour after the patient has undergone scanning. This waiting period could take away time from another patient who needs to undergo scanning.  
• CT should be primarily used for hospitalized and symptomatic patients with definitive needs for CT scans. Necessary disinfection protocol should be taken after the patient has been scanned.
  

The surfaces of CXRs can be easily cleaned, which makes them optimal radiography devices for ambulatory care facilities and prevents the need to bring patients into imaging rooms.

You can read the full recommendation here.