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Morrill S, Baerlocher MO, Patlas MN, Kanani S, Kantarevic J, van der Pol CB. CT, MRI, and Medical Radiation Technologist Trends in Ontario. Can Assoc Radiol J 2024; 75:432-434. [PMID: 37932882 DOI: 10.1177/08465371231209923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Affiliation(s)
| | | | - Michael N Patlas
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | | | | | - Christian B van der Pol
- McMaster University, Hamilton, ON, Canada
- Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, ON, Canada
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Hawkins E, Stewart B, Huggins M, Compson K, Larsen P, Rogan A. What effect did the New Zealand COVID-19 lockdown have on computed tomography-head scan utilisation in patients presenting to the emergency department with traumatic head injuries? Emerg Med Australas 2024; 36:94-100. [PMID: 37848234 DOI: 10.1111/1742-6723.14322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/31/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To explore the unique impact the first COVID-19 national lockdown in New Zealand (NZ) had on the utility of computed tomography (CT)-head scanning in patients presenting to the ED with head injuries. METHODS Retrospective observational study of CT-head use in head-injured patients presenting to the ED during the 2020 COVID-19 lockdown compared to the corresponding time period in 2019. RESULTS During the lockdown period in 2020, the total number of ED presentations reduced by 30.3% (95% confidence interval [CI] 28.8-31.6) from 13 477 to 9403. The total number of head injury presentations also reduced by 32% (95% CI 27-36.7) from 523 to 356. The proportion of head-injured patients remained similar (3.9% [n = 523] in 2019 vs 3.8% [n = 356] in 2020). Of the head injured patients, 185 (51.9%, 95% CI 44.5-59.4) had CT-head scans performed in 2020 compared to 269 (51.4%, 95% CI 45.2-57.5) in 2019; a reduction of 31.2% (95% CI 24.5-37.9). The proportion of patients who had a CT-head scan remained similar (51.4% [95% CI 45.2-57.5] in 2019 vs 51.9% [95% CI 44.5-59.4] in 2020). There were no significant differences in the proportion of CT-head scans with acute traumatic pathology (13.0% [95% CI 8.7-17.3] in 2019 vs 12.4% [95% CI 7.4-17.5] in 2020, P = 0.86). CONCLUSIONS During the first COVID-19 lockdown in NZ, the total number of patients presenting to the ED decreased by one third. Reassuringly, the proportion of patients who presented with head injuries, had a CT-head scan performed, and had positive CT-head findings remained the same as the previous year.
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Affiliation(s)
- Eden Hawkins
- Department of Surgery and Anaesthesia, University of Otago, Wellington, Wellington, New Zealand
| | - Beatrice Stewart
- Department of Surgery and Anaesthesia, University of Otago, Wellington, Wellington, New Zealand
| | - Margaret Huggins
- Department of Surgery and Anaesthesia, University of Otago, Wellington, Wellington, New Zealand
| | - Kathryn Compson
- Wellington Emergency Department, Wellington Regional Hospital, Wellington, New Zealand
| | - Peter Larsen
- Department of Surgery and Anaesthesia, University of Otago, Wellington, Wellington, New Zealand
| | - Alice Rogan
- Department of Surgery and Anaesthesia, University of Otago, Wellington, Wellington, New Zealand
- Wellington Emergency Department, Wellington Regional Hospital, Wellington, New Zealand
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Arıkan C, Bora ES, Kanter E, Karaarslan FN. Have Chest Imaging Habits Changed in the Emergency Department after the Pandemic? Tomography 2023; 9:2079-2088. [PMID: 37987349 PMCID: PMC10661323 DOI: 10.3390/tomography9060163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
The rate of patients undergoing tomography in the emergency department has increased in the last two decades. In the last few years, there has been a more significant increase due to the effects of the pandemic. This study aimed to determine the rate of patients who underwent chest imaging in the emergency department, the preferred imaging method, and the demographic characteristics of the patients undergoing imaging during the pre-pandemic and post-pandemic periods. This retrospective cross-sectional study included patients admitted to the emergency department between January 2019 and March 2023. The number of female, male, and total emergency admissions, the rate of patients who underwent chest X-ray (CXR) and chest computed tomography (CCT), and the age and gender distribution of the cases who underwent chest imaging were compared according to the pre-pandemic (January 2019-February 2020), pandemic (March 2020-March 2022), and post-pandemic (April 2022-March 2023) periods. Total emergency admissions were similar in the pre-pandemic and post-pandemic periods (pre-pandemic period: 21,984 ± 2087; post-pandemic period: 22,732 ± 1701). Compared to the pre-pandemic period, the CCT rate increased (pre-pandemic period: 4.9 ± 0.9, post-pandemic period: 7.46 ± 1.2), and the CXR rate decreased (pre-pandemic period: 16.6 ± 1.7%, post-pandemic period: 13.3 ± 1.9%) in the post-pandemic period (p < 0.001). The mean age of patients who underwent chest imaging (CXR; Pre-pandemic period: 56.6 ± 1.1 years; post-pandemic period: 53.3 ± 5.6 years. CCT; Pre-pandemic period: 68.5 ± 1.7 years; post-pandemic period: 61 ± 4.0 years) in the post-pandemic period was lower than in the pre-pandemic period (p < 0.001). Chest imaging preferences in the emergency department have changed during the post-pandemic period. In the post-pandemic period, while younger patients underwent chest imaging in the emergency department, CCT was preferred, and the rate of CXR decreased. It is alarming for public health that patients are exposed to higher doses of radiation at a younger age.
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Affiliation(s)
- Cüneyt Arıkan
- Department of Emergency Medicine, Soma State Hospital, Manisa 45500, Turkey;
| | - Ejder Saylav Bora
- Department of Emergency Medicine, Izmir Ataturk Training and Research Hospital, Izmir 35150, Turkey;
| | - Efe Kanter
- Department of Emergency Medicine, Izmir Kâtip Çelebi University, Izmir 35620, Turkey;
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Dowhanik SPD, Schieda N, Patlas MN, Salehi F, van der Pol CB. Doing More With Less: CT and MRI Utilization in Canada 2003-2019. Can Assoc Radiol J 2022; 73:592-594. [PMID: 34892979 DOI: 10.1177/08465371211052012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
| | - Nicola Schieda
- Department of Diagnostic Imaging, 6363The Ottawa Hospital- Civic Campus, Ottawa, ON, Canada
| | - Michael N Patlas
- 3710McMaster University, Hamilton, ON, Canada.,Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Fateme Salehi
- 3710McMaster University, Hamilton, ON, Canada.,Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Christian B van der Pol
- 3710McMaster University, Hamilton, ON, Canada.,Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, ON, Canada
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Impact of the COVID pandemic on emergency department CT utilization: where do we go from here? Emerg Radiol 2022; 29:879-885. [PMID: 35729442 PMCID: PMC9212207 DOI: 10.1007/s10140-022-02071-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022]
Abstract
Purpose To analyze the impact of the coronavirus disease (COVID) pandemic on emergency department (ED) computed tomography (CT) utilization. Methods A retrospective observational study was conducted assessing seven hospitals’ ED imaging volumes between Jan. 6, 2019, and Feb. 27, 2021. Weekly CT utilization is reported as CTs ordered per 100 ED visits. Utilization was ascertained in aggregate and by body area. Interrupted time series analysis was performed to assess significance of utilization change. Prespecified sensitivity analysis was performed for influenza-like or COVID-like illness (ILI/CLI). Results Weekly ED CT utilization increased from 35.9 CTs per 100 visits (95% confidence interval [95% CI] 35.8–36.1) to 41.8 per 100 visits (95% CI 41.7–42.0) in pre- and post-pandemic periods. Weekly ED CT chest utilization increased immediately following the pandemic declaration (+ 0.52 chest CTs per 100 ED visits, 95% CI 0.01–1.03, p < 0.05) and compared to pre-pandemic period (+ 0.02 per 100 ED visits, 95% CI 0.02–0.05, p < 0.02). For both CT abdomen/pelvis and CT head, there was neither an immediate effect (+ 0.34 CT-AP per 100 ED visits, 95% CI − 0.74 to 1.44, p = 0.89; − 0.42 CT-H per 100 ED visits, 95% CI − 1.53 to 0.70, p = 0.46) nor a change in weekly CT utilization (+ 0.03 CT-AP per 100 ED visits, 95% CI − 0.01 to 0.05, p = 0.09; + 0.03 CT-H per 100 ED visits, 95% CI − 0.01 to 0.06, p = 0.10). Conclusion These data may help formulate future strategies for resource utilization and imaging operations as we envision a future with COVID and other federal mandates affecting imaging utilization and appropriateness. Supplementary Information The online version contains supplementary material available at 10.1007/s10140-022-02071-z.
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Impact of COVID-19 Pandemic on Trauma CT Imaging. Radiol Res Pract 2022; 2022:9596148. [PMID: 35694183 PMCID: PMC9184200 DOI: 10.1155/2022/9596148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/04/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The goal of this study was to understand the impact of COVID-19 pandemic and associated lockdown measures on the volume, rate, and type of trauma presenting to the emergency department (ED) by using trauma-initiated CT studies to capture patient data. Materials and Methods We performed a retrospective observational study comparing patients undergoing CT scans for trauma during the 1st and 2nd lockdown periods compared to corresponding prepandemic months. During two lockdown periods, public places such as restaurants, libraries, parks, and shops across the province were shut down. Government-led messaging advised that people should stay at home and practice social distancing. The rate of trauma-initiated CT scans and the proportion of different types of traumas were compared between time periods. Results There was no significant difference in overall trauma-initiated CT scans between the prepandemic and pandemic levels. Motor vehicle collision (MVC) cases decreased from 18.2% to 15.6% during the first lockdown period (p = 0.049) and also reduced from 29.1% to 25.2% during the second lockdown period (p = 0.013). Trauma from falls increased from 19.1% to 27.5% (p = 0.036) during the first lockdown, despite no significant change during the 2nd lockdown. Furthermore, the percentage of stab injuries increased from 25.0% to 38.9% while blunt trauma decreased from 68.5% to 54.3% during two lockdowns (p = 0.015). Conclusion The total number of trauma-initiated CT scans did not significantly decrease during the lockdown periods. Stabbings and falls increased during lockdown periods while MVCs and blunt trauma decreased.
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Cau R, Faa G, Nardi V, Balestrieri A, Puig J, Suri JS, SanFilippo R, Saba L. Long-COVID diagnosis: from diagnostic to advanced AI-driven models. Eur J Radiol 2022; 148:110164. [PMID: 35114535 PMCID: PMC8791239 DOI: 10.1016/j.ejrad.2022.110164] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/19/2022]
Abstract
SARS-COV 2 is recognized to be responsible for a multi-organ syndrome. In most patients, symptoms are mild. However, in certain subjects, COVID-19 tends to progress more severely. Most of the patients infected with SARS-COV2 fully recovered within some weeks. In a considerable number of patients, like many other viral infections, various long-lasting symptoms have been described, now defined as “long COVID-19 syndrome”. Given the high number of contagious over the world, it is necessary to understand and comprehend this emerging pathology to enable early diagnosis and improve patents outcomes. In this scenario, AI-based models can be applied in long-COVID-19 patients to assist clinicians and at the same time, to reduce the considerable impact on the care and rehabilitation unit. The purpose of this manuscript is to review different aspects of long-COVID-19 syndrome from clinical presentation to diagnosis, highlighting the considerable impact that AI can have.
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Paez D, Mikhail-Lette M, Gnanasegaran G, Dondi M, Estrada-Lobato E, Bomanji J, Vinjamuri S, El-Haj N, Morozova O, Alonso O, Pellet O, Orellana P, Navarro MC, Delgado Bolton RC, Giammarile F. Nuclear Medicine Departments in the Era of COVID-19. Semin Nucl Med 2022; 52:41-47. [PMID: 34243905 PMCID: PMC8216881 DOI: 10.1053/j.semnuclmed.2021.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
From the outset of the COVID-19 pandemic we, the nuclear medicine (NM) community, expediently mobilized to enable continuity of essential services to the best of our abilities. For example, we effectuated adapted guidelines for NM standard operating procedures (SOPs) and enacted heightened infection protection measures for staff, patients, and the public, alike. Challenges in radionuclide supply chains were identified and often met. NM procedural volumes declined globally and underwent restoration of varying degrees, contingent upon local contexts. Serial surveys have gauged and chronicled such geographical variance of the impact of COVID-19 on NM service delivery and, though it may be too early to fully understand the long-term consequences of reduced NM services, overall, we can certainly expect that this era adversely affected the management of many patients afflicted with non-communicable diseases. Today we are unquestionably better prepared to face unforeseen outbreaks, but a degree of uncertainty lingers. Which lessons learned will endure in the form of permanent NM pandemic preparedness procedures and protocols? In this spirit, the present manuscript presents a revision of prior recommendations issued mid-pandemic to NM centers, some of which may become mainstays in NM service delivery and implementation. Discussed herein are (1) comparative worldwide survey results of the measurable impact of COVID-19 on the practice of nuclear medicine (2) the definitions of a pandemic and its phases (3) relevant, recently developed or updated guidelines specific to nuclear medicine (4) incidental findings of COVID-19 on hybrid nuclear medicine studies performed primarily for oncologic indications and (5) how pertinent pedagogical methods for medical education, research, and development have been re-invented in a suddenly more virtual world. NM professionals shall indefinitely adopt many of the measures implemented during this pandemic, to enable continuity of essential services while preventing the spread of the virus. Which ones? Practices must remain ready for possible new peaks or variants of the roiling COVID-19 contagion and for the emergence of potential new pathogens that may incite future outbreaks or pandemics. Communications technologies are here to stay and will continue to be used in a broad spectrum of applications, from telemedicine to education, but how best? NM departments must align synergistically with these trends, considering what adaptations to a more virtual professional environment should not only last but be further innovated. The paper aims to provide recent history, analysis, and a springboard for continued constructive dialogue. To best navigate the future, NM must continue to learn from this crisis and must continue to bring new questions, evidence, ideas, and warranted systematic updates to the figurative table.
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Affiliation(s)
- Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria,Address reprint requests to: Diana Paez, Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, PO Box 100, 1400 Vienna, Austria
| | - Miriam Mikhail-Lette
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | | | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Enrique Estrada-Lobato
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, London, United Kingdom
| | | | - Noura El-Haj
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Olga Morozova
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Omar Alonso
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Olivier Pellet
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Pilar Orellana
- Department of Nuclear Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria C. Navarro
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Roberto C. Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
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Awan OA, Chan S, Ros P. The Radiology Landscape after COVID-19: Summary of the 2021 AUR Academic Radiology and Industry Leaders Roundtable. Acad Radiol 2021; 28:1582-1585. [PMID: 34511328 DOI: 10.1016/j.acra.2021.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/15/2021] [Accepted: 08/28/2021] [Indexed: 12/01/2022]
Abstract
The fifth Association of University Radiologists (AUR) Academic Radiology and Leaders Roundtable took place the day after the conclusion of the AUR annual meeting in May 2021 and involved leaders in academic radiology departments across the United States, and industry from companies who provide quintessential services to radiology departments. The open-ended discussion identified the key challenges facing the practice and business of radiology as we jointly move forward after the COVID-19 pandemic. Particular attention was paid to the identification of viable solutions that radiology departments should embrace to sustain clinical productivity, innovation, and well-being, and the ways that industry could contribute significantly to that endeavor.
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Affiliation(s)
- Omer A Awan
- University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD 21201 (O.A.A); Columbia University Medical Center, 630 W 168th Street, New York, NY 10032 (S.C.); Stony Brook University, 101 Nicolls Rd, HSC L4, Room 120, Stony Brook, NY 11794 (P.R.).
| | - Stephen Chan
- University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD 21201 (O.A.A); Columbia University Medical Center, 630 W 168th Street, New York, NY 10032 (S.C.); Stony Brook University, 101 Nicolls Rd, HSC L4, Room 120, Stony Brook, NY 11794 (P.R.)
| | - Pablo Ros
- University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD 21201 (O.A.A); Columbia University Medical Center, 630 W 168th Street, New York, NY 10032 (S.C.); Stony Brook University, 101 Nicolls Rd, HSC L4, Room 120, Stony Brook, NY 11794 (P.R.)
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KÜÇÜKCERAN K, AYRANCI MK. The Effect of a Pandemic on Computed Tomography Pulmonary Angiography Results and Utilize in the Emergency Department. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.994118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Alaref A, Elnayal A, Kulkarni A, Alabousi A, Van Der Pol C. Burnout Exacerbation due to COVID-19 Pandemic. Can Assoc Radiol J 2021; 73:272. [PMID: 34139870 DOI: 10.1177/08465371211022291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Amer Alaref
- Northern Ontario School of Medicine (NOSM), 27373Thunder Bay Regional Health Science Center (TBRHSC), Thunder Bay, Ontario, Canada
| | - Amr Elnayal
- Al Hada Military Hospital, KSA, Saudi Arabia
| | - Ameya Kulkarni
- Department of Radiology, 3710McMaster University, The Juravinski Hospital, Hamilton, Canada
| | - Abdullah Alabousi
- Department of Radiology, 3710McMaster University, St. Joseph's Healthcare, Hamilton, Canada
| | - Christian Van Der Pol
- Department of Radiology, 3710McMaster University, The Juravinski Hospital, Hamilton, Canada
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