ACR Statement on Safe Resumption of Routine Radiology Care During the Coronavirus Disease 2019 (COVID-19) Pandemic

Abstract

The ACR recognizes that radiology practices are grappling with when and how to safely resume routine radiology care during the coronavirus disease 2019 (COVID-19) pandemic. Although it is unclear how long the pandemic will last, it may persist for many months. Throughout this time, it will be important to perform safe, comprehensive, and effective care for patients with and patients without COVID-19, recognizing that asymptomatic transmission is common with this disease. Local idiosyncrasies prevent a single prescriptive strategy. However, general considerations can be applied to most practice environments. A comprehensive strategy will include consideration of local COVID-19 statistics; availability of personal protective equipment; local, state, and federal government mandates; institutional regulatory guidance; local safety measures; health care worker availability; patient and health care worker risk factors; factors specific to the indication(s) for radiology care; and examination or procedure acuity. An accurate risk-benefit analysis of postponing versus performing a given routine radiology examination or procedure often is not possible because of many unknown and complex factors. However, this is the overriding principle: If the risk of illness or death to a health care worker or patient from health care-acquired COVID-19 is greater than the risk of illness or death from delaying radiology care, the care should be delayed; however, if the opposite is true, the radiology care should proceed in a timely fashion.

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic

“…As the first peak phase passes, semi-urgent and elective CMR examinations can begin to be scheduled. The American College of Radiology (ACR) has provided guidance on the safe resumption of non-urgent diagnostic imaging, while a consensus document from multiple North American cardiovascular societies has outlined procedures for safe re-introduction of cardiovascular services [11,12]. According to the ESCR, cardiac imaging programs should be firstly reopened to patients with "subacute" indications that were rescheduled during the pandemic, whereas pre-operative scans may be scheduled close to the surgical procedures [7].…”

Impact of the COVID-19 crisis on imaging in oncological trials

“…With imaging so integral to clinical trials in oncology, it is crucial that cancer research is not held back by failure to deliver timely imaging, compliant to protocol. Pathways where imaging studies can be directed to local sites with spare capacity, semi-automated readouts to reduce staff pressure and facilities that exclude potentially infectious patients need to be within institutional policies, to pre-empt and minimise disruption to imaging within research trials in future pandemics [25]. Ongoing adaptations could be the creation of safer pathways, dedicated to vulnerable patients within imaging units and hospitals and minimisation of potential exposure to pathogens through grouped clinical, laboratory and imaging visits.…”

Defining the Recovery

“…"Patient-centered care" assumed a more urgent meaning as we sought to keep patients away from health care facilities to reduce their risk. The ACR provides guidance on safe resumption of routine care as we prepare to welcome patients back [8]. An expert panel also provides recommendations on management of lung nodules during the pandemic [9,10].…”