Imaging volumes during COVID-19: A Victorian health service experience

Abstract

BACKGROUND The World Health Organisation declared the coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020. While globally, the relative caseload has been high, Australia’s has been relatively low. During the pandemic, radiology services have seen significant changes in workflow across modalities and a reduction in imaging volumes. AIM To investigate differences in modality imaging volumes during the COVID-19 pandemic across a large Victorian public health network. METHODS A retrospective analysis from January 2019 to December 2020 compared imaging volumes across two periods corresponding to the pandemic’s first and second waves. Weekly volumes across patient class, modality and mobile imaging were summed for periods: wave 1 (weeks 11 to 16 for 2019; weeks 63 to 68 for 2020) and wave 2 (weeks 28 to 43 for 2019; weeks 80 to 95 for 2020). Microsoft Power Business Intelligence linked to the radiology information system was used to mine all completed examinations. RESULTS Summed weekly data during the pandemic’s first wave showed the greatest decrease of 29.8% in adult outpatient imaging volumes and 46.3% in paediatric emergency department imaging volumes. Adult nuclear medicine demonstrated the greatest decrease of 37.1% for the same period. Paediatric nuclear medicine showed the greatest decrease of 47.8%, with angiography increasing by 50%. The pandemic’s second wave demonstrated the greatest decrease of 23.5% in adult outpatient imaging volumes, with an increase of 18.2% in inpatient imaging volumes. The greatest decrease was 28.5% in paediatric emergency department imaging volumes. Nuclear medicine showed the greatest decrease of 37.1% for the same period. Paediatric nuclear medicine showed the greatest decrease of 36.7%. Mobile imaging utilisation increased between 57.8% and 135.1% during the first and second waves. A strong correlation was observed between mobile and non-mobile imaging in the emergency setting (Spearman’s correlation coefficient = -0.743, P = 0.000). No correlation was observed in the inpatient setting (Spearman’s correlation coefficient = -0.059, P = 0.554). CONCLUSION Nuclear medicine was most impacted, while computed tomography and angiography were the least affected by the pandemic. The impact was less during the pandemic’s second wave. Mobile imaging shows continuous growth during both waves.

A Global Review of the Impacts of the Coronavirus (COVID-19) Pandemic on Radiology Practice, Finances, and Operations

“…Ultrasound, mammography, and magnetic resonance imaging (MRI) were the modalities most affected during this period [18]. A study of imaging volume across Victoria, Australia, noted a 20.7% decrease in imaging volume between 11 March 2020 and 21 April 2020 compared with the same timeframe in 2019 [10]. The subsections of nuclear medicine, mammography, and magnetic resonance imaging had the largest decreases in volume [10].…”

“…A study of imaging volume across Victoria, Australia, noted a 20.7% decrease in imaging volume between 11 March 2020 and 21 April 2020 compared with the same timeframe in 2019 [10]. The subsections of nuclear medicine, mammography, and magnetic resonance imaging had the largest decreases in volume [10]. A multicenter survey of chest CT scans in Iran between 2019 and 2020 found that there was a 50.2% increase in chest CT volume compared with 2018 to 2019.…”

“…The decrease in overall patient volumes led to a decreased need for imaging within hospital systems. Consequently, both imaging volumes and revenue generation were lower during the initial stages of the COVID-19 pandemic [9,10].…”