A major advantage of digital imaging for general radiography is the potential for reduced patient dose so film/screen systems should be phased out as unnecessarily hazardous

Effectiveness of fever tent setup in Covid-19 pandemic – from radiology's perspective

Introduction

This paper describes our experience in setting up a dedicated imaging facility within a temporary fever tentage in an acute tertiary hospital in Singapore during the coronavirus disease 2019 (COVID-19) pandemic. We review the effectiveness of the setup and its role from the radiological perspective in detail.

Methods

The dedicated imaging facility within the temporary fever tentage was equipped with a computer-on-wheels (COWs) to access patients’ medical records and a portable x-ray machine to allow for a smooth workflow. Radiation dose measurements were acquired around the imaging facility using phantoms and dosimeters to ensure radiation safety.

Results

Due to its rapid nature and availability as a screening tool, chest x-ray (CXR) is the most widely used imaging modality during the COVID-19 pandemic. Our dedicated fever tent setup minimizes possible in-hospital transmission between both patients and staff and provides a more streamlined workflow to tackle the high workload. It allowed us to reduce the time required for each radiograph, providing timely imaging services and radiological reports for expedient clinical screening.

Discussion

The close collaboration between Radiology and Emergency Departments in setting up the fever tentage is a crucial tool in managing the COVID-19 pandemic. The fever tentage imaging facility is a highly effective tool, providing the means to handle the increased patient load in a streamlined and safe manner during a pandemic.

Conclusion

This paper provides insights and guidelines in setting up a dedicated imaging service within the fever tent for future infectious disease outbreak contingency plans.

Initial quality performance results using a phantom to simulate chest computed radiography

The aim of this study was to develop a homemade phantom for quantitative quality control in chest computed radiography (CR). The phantom was constructed from copper, aluminium, and polymenthylmethacrylate (PMMA) plates as well as Styrofoam materials. Depending on combinations, the literature suggests that these materials can simulate the attenuation and scattering characteristics of lung, heart, and mediastinum. The lung, heart, and mediastinum regions were simulated by 10 mm x 10 mm x 0.5 mm, 10 mm x 10 mm x 0.5 mm and 10 mm x 10 mm x 1 mm copper plates, respectively. A test object of 100 mm x 100 mm and 0.2 mm thick copper was positioned to each region for CNR measurements. The phantom was exposed to x-rays generated by different tube potentials that covered settings in clinical use: 110-120 kVp (HVL=4.26-4.66 mm Al) at a source image distance (SID) of 180 cm. An approach similar to the recommended method in digital mammography was applied to determine the CNR values of phantom images produced by a Kodak CR 850A system with post-processing turned off. Subjective contrast-detail studies were also carried out by using images of Leeds TOR CDR test object acquired under similar exposure conditions as during CNR measurements. For clinical kVp conditions relevant to chest radiography, the CNR was highest over 90-100 kVp range. The CNR data correlated with the results of contrast detail observations. The values of clinical tube potentials at which CNR is the highest are regarded to be optimal kVp settings. The simplicity in phantom construction can offer easy implementation of related quality control program.