COVID-19 radiology CT personnel management

A new coronavirus outbreak called COVID-19 started in December 2019. In Turkey, the first case was reported on 10 March 2020. In this article, information will be given about the patient and staff management and organization that we have implemented in the Radiology Department of our hospital during the COVID-19 pandemic. The rules we followed were: 1- Performing the examinations of COVID-19 patients and suspects with a CT device isolated from other patients; 2- Reducing the unnecessary workload in imaging modalities other than CT, emergency radiography, and emergency ultrasonography; 3- Directing and managing patients and their relatives in accordance with the mask and distancing rules; 4- Disinfecting the device with an appropriate disinfectant after each patient in order to prevent cross-contamination; 5- Protecting the entire technician team from infection by employing one week work, two weeks off shifts of fixed teams; 6- Ensuring adequate ventilation of the gantry room. Adhering to the above rules, no infection spread was reported from the Radiology department and especially the COVID-19 CT unit.

In December 2019, a new coronavirus outbreak called COVID-19 was reported in China (1). On March 11, 2020, the World Health Organization (WHO) announced that it became a pandemic (2), and the incubation period of the disease was reported to be in the range of 2 to 10 days (3). Later, it became evident that the virus caused a highly contagious disease by transmitting from person to person through respiratory droplets and from surfaces contaminated with the virus (4–6), and that the incubation period can vary between 1 and 19 days (7). In Turkey, the first case was detected on 10 March 2020. The National Coordination Board also convened on the same day. Like most countries, our country has set targets within the framework of the following strategies in combating the epidemic. These strategies are: 1) slowing and halting disease spread, preventing epidemics and delaying the spread; 2) providing optimized care for all patients, especially those with severe diseases; and 3) minimizing the impact of the epidemic on health systems, social services and economic activity (8). After the coordination board meeting, a series of measures were taken by the Ministry of Health in our country to prevent the spread of COVID-19. In this context, by using all media channels in our country, both the public and the health personnel were informed about the disease; announcements were made about the hygiene rules and trainings were started. Those with a travel history abroad were quarantined for 14 days, even if they did not have symptoms of the disease. If symptoms occurred in these individuals, possible case management algorithms were applied (9). Like all institutions, pandemic committees have been established in our hospital and necessary measures have been taken. While only preventive measures were taken to limit the spread of COVID-19 in non-healthcare-related institutions, the planning in hospitals is not one-sided, and requires multi-directional and comprehensive planning. All diagnostic and treatment-related services in hospitals should be reorganized to prevent the transmission of the virus from patient to patient, patient to patient relatives, patient to staff and staff to patients. In this context, serious changes need be made in the management of patients and personnel to ensure the continuity of work in the Radiology departments throughout the epidemic. In other words, while providing services to COVID-19 patients, the risk of transmitting the disease to other patients and staff should be minimized (10). In this article, we summarize the patient and personnel management and organization that we have implemented in the Radiology Department of Ege University hospital during the COVID-19 outbreak.     

放射影像技术在创伤急救中的合理应用

自从1895年德国物理学家伦琴(Wilhem Conrad Rontgen)发现X射线以来,放射影像技术迅速发展至如今的CT、CT血管造影(CTA)、数字减影血管造影(DSA)、MRI等多种技术及正电子发射计算机断层扫描(PET)等,虽然各种成像技术的成像原理与方法不同,属于诊断的范畴,但由此衍生出的介入治疗技术,使放射影像技术步入了治疗阶段,在创伤的诊断和急救中有着越来越重要的地位.合理应用这些技术将更好更快地为创伤急救服务.     

放射影像技术在创伤急救中的合理应用

自从1895年德国物理学家伦琴(Wilhem Conrad Rontgen)发现X射线以来,放射影像技术迅速发展至如今的CT、CT血管造影(CTA)、数字减影血管造影(DSA)、MRI等多种技术及正电子发射计算机断层扫描(PET)等,虽然各种成像技术的成像原理与方法不同,属于诊断的范畴,但由此衍生出的介入治疗技术,使放射影像技术步入了治疗阶段,在创伤的诊断和急救中有着越来越重要的地位.合理应用这些技术将更好更快地为创伤急救服务.     

Container CT scanner: a solution for modular emergency radiology department during the COVID-19 pandemic

During the coronavirus disease 2019 (COVID-19) pandemic period, container computed tomography (CT) scanners were developed and used for the first time in China to perform CT examinations for patients with clinically mild to moderate COVID-19 who did not need to be hospitalized for comprehensive treatment, but needed to be isolated in Fangcang shelter hospitals (also known as makeshift hospitals) to receive some supportive treatment. The container CT is a multidetector CT scanner installed within a radiation-protected stand-alone container (a detachable lead shielding room) that is deployed outside the makeshift hospital buildings. The container CT approach provided various medical institutions with the solution not only for rapid CT installation and high adaptability to site environments, but also for significantly minimizing the risk of cross-infection between radiological personnel and patients during CT examination in the pandemic. In this article, we described the typical setup of a container CT and how it worked for chest CT examinations in Wuhan city, the epicenter of COVID-19 outbreak.

Fangcang shelter hospitals, also known as makeshift hospitals, were developed and used for the first time in China to tackle the coronavirus disease 2019 (COVID-19) outbreak by providing medical care and disease monitoring for patients with mild to moderate COVID-19 who were isolated from their families and communities (1). Similarly, stand-alone computed tomography (CT) scanners, known as container CTs, were developed and used for the first time in China to perform CT examinations on patients with clinically mild to moderate COVID-19 who received supportive treatment at makeshift hospitals. These container CTs were first deployed outside makeshift hospital buildings and later also at some regular hospitals as stand-alone CT scanners designated for fever patients and confirmed COVID-19 patients.Chest CT images have been widely used to help with early diagnosis, assess the degree of pulmonary infectious involvement, monitor disease progression, and evaluate treatment effects (2). These CT examinations were originally performed in regular hospital settings with normally installed CT scanners. However, at makeshift hospitals that were converted from civil building facilities such as stadiums, schools, and exhibition halls, no space was available that could meet the shielding and radiation protection standards necessary to install CT scanners. Furthermore, during that critical pandemic period, many hospitals in Wuhan urgently needed to be equipped with more CT scanners to rapidly improve the imaging examination capabilities for patients with fever, suspected patients, and patients with confirmed COVID-19. Unfortunately, these hospitals usually lack readily available sites for rapid CT installations because it normally takes at least a month to build or remodel a CT shielding room even without the complications of the complete lockdown in Wuhan city. To figure out this issue, under tremendous pressure to rapidly install new CT scanners at both regular hospitals and makeshift hospitals, Chinese medical equipment companies worked closely with frontline radiologists and technologists and developed an innovative container CT, which functions as a modular emergency radiology department. To date, more than 140 container CTs have been installed at makeshift hospitals and regular hospitals in China since the COVID-19 outbreak.In this article, we presented a typical in-depth solution for container CT deployment in Wuhan during the COVID-19 outbreak.     

COVID-19: A call for mentorship in radiology

During the COVID-19 pandemic, mentorship relationships have undergone significant strain. Sudden changes in the practice environment have caused radiologists to focus their attention to more immediate and essential clinical needs, thus leaving important extracurricular non-clinical endeavors like mentorship by the wayside. However, mentorship is essential more than ever during the pandemic to build strength and resilience in radiology. Specifically, mentorship can foster job resilience, facilitate career development, promote diversity, support wellness, and stimulate future practice growth during this pandemic. Practical actions are described that mentors can follow to help develop and sustain mentorship relationships during the pandemic.SummaryMentorship is critical now during the COVID-19 pandemic to build strength and resilience in radiology.     

Impact of the COVID-19 pandemic on radiology physician work RVUs at a large subspecialized radiology practice

PurposeAs the COVID-19 pandemic continues, efforts by radiology departments to protect patients and healthcare workers and mitigate disease spread have reduced imaging volumes. This study aims to quantify the pandemic's impact on physician productivity across radiology practice areas as measured by physician work Relative Value Units (wRVUs).Materials and methodsAll signed diagnostic and procedural radiology reports were curated from January 1st to July 1st of 2019 and 2020. Physician work RVUs were assigned to each study type based on the Medicare Physician Fee Schedule. Utilizing divisional assignments, radiologist schedules were mapped to each report to generate a sum of wRVUs credited to that division for each week. Differential impact on divisions were calculated relative to a matched timeframe in 2019 and a same length pre-pandemic time period in 2020.ResultsAll practice areas saw a substantial decrease in wRVUs from the 2020 pre- to intra-pandemic time period with a mean decrease of 51.5% (range 15.4%–76.9%). The largest declines were in Breast imaging, Musculoskeletal, and Neuroradiology, which had decreases of 76.9%, 75.3%, and 67.5%, respectively. The modalities with the greatest percentage decrease were mammography, MRI, and non-PET nuclear medicine.ConclusionAll radiology practice areas and modalities experienced a substantial decrease in wRVUs. The greatest decline was in Breast imaging, Neuroradiology, and Musculoskeletal radiology. Understanding the differential impact of the pandemic on practice areas will help radiology departments prepare for the potential depth and duration of the pandemic by better understanding staffing needs and the financial effects.     

The impact of COVID-19 upon student radiographers and clinical training

IntroductionTo investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning.MethodsBetween mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases.Results1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use.ConclusionStudent radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience.Implications for practiceAs the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.     

The radiology of chest trauma.

This paper deals with chest trauma, both blunt and penetrative. The emphasis is on the significance of various manifestations of trauma and the indications for further radiologic study.     

Future scenarios and opportunities for interventional radiology in the post COVID-19 era

Pandemic outbreak has led health systems worldwide into a rapid reorganization in response to coronavirus infections, forcing interventional radiology units to adapt. Interventional procedures have evolved in number, type and setting and have arguably been optimized as a direct consequence of this pandemic; a result that will undoubtedly lead to radical change within the specialty. This paper explores the future of interventional radiology from various perspectives, and forecasts the new opportunities that will be presented, from the adaptation of the interventional radiology staff and angiography suite, to the immunological environment, and through to digital medical education. We analyze the economic impact and the future relationship we can expect with the rest of the medical industry.

Rapid outbreak of the coronavirus disease 2019 (COVID-19) has led to an unprecedented knockdown of health systems worldwide. During the first weeks of the pandemic, a rapidly growing number of patients required immediate hospitalization, and many of them were admitted to intensive care units (ICU). Human, economic, and medical resources have been redistributed to fight against the pandemic spread. Widely varied rates of virus evolution in terms of time and severity have been observed between the nations, and whilst this allows us to theorize on the course of the disease, many uncertainties remain as how the disease will evolve in the short- to midterm (1).Narrowing to the field of interventional radiology (IR), we have been forced to adapt our practices to this situation in a very short period of time. An abrupt stop was made to daily practices, with priority being given to only the most urgent oncologic and trauma procedures, and other basic services necessary to fight against the disease on the front line.The purpose of this article is to explore how IR may evolve over the next 1–3 years. The authors do not pretend to predict or fix ideas about what will happen, rather, they share hypothesis on what may occur, with the aim to spark meaningful reflection and debate. This article has been designed to inspire bold thinking about this inevitable era of change and opportunity, always with the conviction that our “resilient” specialty will prevail as it has done for generations.     

The impact of teaching experimental research on-line: Research-informed teaching and COVID-19

IntroductionAs part of the BSc (Hons) Diagnostic Radiography programme students learn and undertake research relevant to their development as first post radiographers (dose optimisation and image quality) within the Research-Informed Teaching experience (RiTe). Due to the COVID-19 pandemic, the delivery of RiTe to our year 2 students was moved to an online format using Microsoft Teams and Blackboard Collaborate and focused on a key area of current practice - COVID-19 and chest X-ray imaging. Within RiTe students are placed into collaborative enquiry-based learning (CEBL) groups to share tasks, but to also support and learn from one another.MethodsAn online survey was used to explore the year 2 student cohort task value and self-efficacy of this online version of RiTe.ResultsA 73% (32/44) response rate was achieved. Students found the online version of RiTe to be a positive learning and development experience. There was strong agreement that they not only found it relevant to their area of practice (task-value), but also strongly agreed that they understood and could master the skills taught (self-efficacy).ConclusionThis online version of RiTe was effectively structured to help scaffold student learning and development of research data analysis skills despite the lack of face-to-face teaching. The students also valued the topic area (COVID-19 and chest X-ray imaging). A blended learning approach with RiTe will be used next year with a combination of collaborative online teaching and physical data collection and analysis in the university-based X-ray imaging laboratory. Further evaluation and data collection will also be undertaken.Implications for practiceUniversity-based empirical work in groups to learn about research can be replaced by an online mechanism whilst still maintaining task-value and acceptable self-efficacy.