Spanish radiographers’ concerns about the COVID-19 pandemic

IntroductionThe current outbreak of COVID-19 has caused worldwide healthcare and social emergency in which healthcare professionals were under extreme work conditions while being fearful of becoming infected or spreading the disease to their relatives. The perceived threat of COVID-19 has the potential to cause severe psychological maladjustment. The aim of the study is to explore Spanish radiographers’ concerns about the COVID-19 pandemic.MethodsThis study was quantitative, observational and cross-sectional. The sample was made up of 546 radiographers working in Spain during the outbreak. The instrument used for analysis was an ad hoc questionnaire with socio-demographic questions and the questionnaire on perception of threat from COVID-19 validate to spanish healthcare professionals.ResultsThe sample consisted of 70.1% of female, 29.7% of male and 0.2% undeclare sex participants. The results showed a high level of a perceived threat from COVID-19 (7.57 ± 0.088), furthermore we observed a high level of threat about the possibility of infecting family members (8.49 ± 0.25), patients (8.33 ± 0.086), and coworkers (8.35 ± 0.084). Furthermore, females have a higher level of a perception of threat to spread infection between patients (r = ?0.136; p = 0.001) and coworkers (r = ?0.118; p = 0.006), than males.ConclusionCOVID-19 pandemic is perceived as a serious threat, being especially concerned about the threat of spreading the infection to family, coworkers, and patients. The perception of risk depends partly on professionals’ gender and family responsibilities.Implications for practiceOur findings suggest that it is recommended that healthcare professionals receive formation to reinforce and improve their emotional competencies for coping successfully with potentially stressful situations like COVI19 pandemic.     

Impact of the COVID-19 pandemic on clinical radiography practice in low resource settings: The Ghanaian radiographers’ perspective

IntroductionThe COVID-19 pandemic has altered the professional practice of all healthcare workers, including radiographers. In the pandemic, clinical practice of radiographers was centred mostly on chest imaging of COVID-19 patients and radiotherapy treatment care delivery to those with cancer. This study aimed to assess the radiographers’ perspective on the impact of the pandemic on their wellbeing and imaging service delivery in Ghana.MethodsA cross-sectional survey of practising radiographers in Ghana was conducted online from March 26th to May 6th, 2020. A previously validated questionnaire that sought information regarding demographics, general perspectives on personal and professional impact of the pandemic was used as the research instrument. Data obtained was analysed using Microsoft Excel® 2016.ResultsA response rate of 57.3% (134/234) was obtained. Of the respondents, 75.4% (n = 101) reported to have started experiencing high levels of workplace-related stress after the outbreak. Three-quarters (n = 98, 73.1%) of respondents reported limited access to any form of psychosocial support systems at work during the study period. Half (n = 67, 50%) of the respondents reported a decline in general workload during the study period while only a minority (n = 18, 13.4%) reported an increase in workload due to COVID-19 cases.ConclusionThis national survey indicated that majority of the workforce started experiencing coronavirus-specific workplace-related stress after the outbreak. Albeit speculative, low patient confidence and fear of contracting the COVID-19 infection on hospital attendance contributed to the decline in general workload during the study period.Implications for practiceIn order to mitigate the burden of workplace-related stress on frontline workers, including radiographers, and in keeping to standard practices for staff mental wellbeing and patient safety, institutional support structures are necessary in similar future pandemics.     

Increased per-patient imaging utilization in an emergency department setting during COVID-19

IntroductionCOVID-19 has resulted in decreases in absolute imaging volumes, however imaging utilization on a per-patient basis has not been reported. Here we compare per-patient imaging utilization, characterized by imaging studies and work relative value units (wRVUs), in an emergency department (ED) during a COVID-19 surge to the same period in 2019.MethodsThis retrospective study included patients presenting to the ED from April 1–May 1, 2020 and 2019. Patients were stratified into three primary subgroups: all patients (n = 9580, n = 5686), patients presenting with respiratory complaints (n = 1373, n = 2193), and patients presenting without respiratory complaints (n = 8207, n = 3493). The primary outcome was imaging studies/patient and wRVU/patient. Secondary analysis was by disposition and COVID status. Comparisons were via the Wilcoxon rank-sum or Chi-squared tests.ResultsThe total patients, imaging exams, and wRVUs during the 2020 and 2019 periods were 5686 and 9580 (−41%), 6624 and 8765 (−24%), and 4988 and 7818 (−36%), respectively, and the percentage patients receiving any imaging was 67% and 51%, respectively (p < .0001). In 2020 there was a 170% relative increase in patients presenting with respiratory complaints. In 2020, patients without respiratory complaints generated 24% more wRVU/patient (p < .0001) and 33% more studies/patient (p < .0001), highlighted by 38% more CTs/patient.ConclusionWe report increased per-patient imaging utilization in an emergency department during COVID-19, particularly in patients without respiratory complaints.     

Radiographer interpretation of trauma radiographs: Issues for radiography education providers

BackgroundThe role of radiographers with respect to image interpretation within clinical practice is well recognised. It is the expectation of the professional, regulatory and academic bodies that upon qualification, radiographers will possess image interpretation skills. Additionally, The College of Radiographers has asserted that its aspiration is for all radiographers to be able to provide an immediate written interpretation on skeletal trauma radiographs by 2010. This paper explores the readiness of radiography education programmes in the UK to deliver this expectation.MethodA postal questionnaire was distributed to 25 Higher Education Institutions in the UK (including Northern Ireland) that provided pre-registration radiography education as identified from the Society & College of Radiographers register. Information was sought relating to the type of image interpretation education delivered at pre- and post-registration levels; the anatomical range of image interpretation education; and education delivery styles.ResultsA total of 19 responses (n = 19/25; 76.0%) were received. Image interpretation education was included as part of all radiographer pre-registration programmes and offered at post-registration level at 12 academic centres (n = 12/19; 63.2%). The anatomical areas and educational delivery methods varied across institutions.ConclusionRadiography education providers have embraced the need for image interpretation education within both pre- and post-registration radiography programmes. As a result, UK education programmes are able to meet the 2010 College of Radiographers aspiration.     

Mediastinal lymphadenopathy may predict 30-day mortality in patients with COVID-19

PurposeThere is scarce data on the impact of the presence of mediastinal lymphadenopathy on the prognosis of coronavirus-disease 2019 (COVID-19). We aimed to investigate whether its presence is associated with increased risk for 30-day mortality in a large group of patients with COVID-19.MethodIn this retrospective cross-sectional study, 650 adult laboratory-confirmed hospitalized COVID-19 patients were included. Patients with comorbidities that may cause enlarged mediastinal lymphadenopathy were excluded. Demographics, clinical characteristics, vital and laboratory findings, and outcome were obtained from electronic medical records. Computed tomography scans were evaluated by two blinded radiologists. Univariate and multivariate logistic regression analyses were performed to determine independent predictive factors of 30-day mortality.ResultsPatients with enlarged mediastinal lymphadenopathy (n = 60, 9.2%) were older and more likely to have at least one comorbidity than patients without enlarged mediastinal lymphadenopathy (p = 0.03, p = 0.003). There were more deaths in patients with enlarged mediastinal lymphadenopathy than in those without (11/60 vs 45/590, p = 0.01). Older age (OR:3.74, 95% CI: 2.06–6.79; p < 0.001), presence of consolidation pattern (OR:1.93, 95% CI: 1.09–3.40; p = 0.02) and enlarged mediastinal lymphadenopathy (OR:2.38, 95% CI:1.13–4.98; p = 0.02) were independently associated with 30-day mortality.ConclusionIn this large group of hospitalized patients with COVID-19, we found that in addition to older age and consolidation pattern on CT scan, enlarged mediastinal lymphadenopathy were independently associated with increased mortality. Mediastinal evaluation should be performed in all patients with COVID-19.     

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.     

Cognisance of magnetic resonance imaging-induced vertigo and supported care: A study among a cohort of MRI radiographers in a country in West Africa

IntroductionMagnetic resonance imaging (MRI) can induce vertigo in patients undergoing such examinations. The severity of the vertigo is thought to increase with higher magnetic field strengths and could cause a patient to fall.The study assessed the awareness levels on MRI-induced vertigo among a cohort of MRI radiographers and their perspectives on the care that should be administered to patients post MRI examinations.MethodsThe study utilized a quantitative cross-sectional research design and a questionnaire. Out of a total of 40 MRI-radiographers identified nationwide, 31 participated in the study. Statistical Package for Social Sciences v.21.0 was used to analyse the data.ResultsMost participants (n = 21, 67.7%) were aware of MRI-induced vertigo. Many knew that patients (able and weaker) need to be assisted off the couch (n = 28, 90.3%) and escorted to the changing rooms post MRI examinations (n = 31,100%). There were statistically significant associations between the size of magnetic field strength used by the participants and their level of awareness about MRI-induced vertigo (r = 0.691, p = 0.003), appreciation of the needed support for patients post MRI examinations (r = 0.530, p = 0.041) and the frequency of occurrence of MRI-induced vertigo among their patients (r = 0.530, p = 0.001).ConclusionThe radiographers were mostly cognisant of MRI-induced vertigo and the supported care they were supposed to administer to their patients. The size of magnetic field strength used by the participants correlated with their level of awareness about MRI-induced vertigo and their appreciation of the needed support for patients post MRI examinations.Implication for practiceThe study highlights the need for a refresher training to expand the knowledge-base of a few of the radiographers who were not very cognisant about MRI-induced vertigo.     

Radiographer's confidence in managing patients with claustrophobia during magnetic resonance imaging

IntroductionClaustrophobia is a major problem experienced by some patients referred for magnetic resonance imaging (MRI). This results in significant costs and delays to healthcare service provision due to appointment cancellations or patients' inability to complete MRI examinations. Radiographers may use several strategies to effectively manage patients with claustrophobia during MRI. This study aimed to determine radiographer's confidence in managing patients with claustrophobia and evaluate the perceived effectiveness of the intervention approaches employed.MethodsWith institutional ethical approval, an online survey was conducted (15th September to 9th November 2020) among Kuwaiti MRI radiographers. The survey was designed to obtain information relating to participant demographics and the perceived confidence of radiographers in their use of interventions to manage claustrophobia during MRI procedures. Data obtained were analysed using the Statistical Package for the Social Sciences (v.26).ResultsA total of 144 valid responses were obtained. Of the respondents, 82% (n = 118) were confident that they could support claustrophobic patients during MRI examinations. Almost all respondents (97.9%, n = 141) employed various claustrophobia reduction and relaxation techniques to improve patient experience and increase scan completion rates. There was a significant association between radiographer’s level of education (r_s = +0.18, p = 0.028) and experience (r_s = +0.33, p < 0.001) with their confidence managing claustrophobic patients. While participating radiographers considered lectures and training the most effective methods to improve their skills in managing such patients, educating claustrophobic patients prior to their MRI scan was the most effective technique for facilitating scan completion.ConclusionKuwaiti MRI radiographers are confident in applying different claustrophobic management techniques to improve patient compliance. Patient education, through supportive discussion, prior to their MRI examination was identified as the most effective intervention for managing claustrophobia.Implications for practicePatient education before MRI examination is necessary to enhance their experience and optimise scan completion rates. In addition, it is essential that MR radiographers develop their practical competence in supporting patients with claustrophobia during their scans.     

Impact of coronavirus disease 2019 (COVID-19) outbreak on radiology research: An Italian survey

PurposeTo understand how COVID-19 pandemic has changed radiology research in Italy.MethodsA questionnaire (n = 19 questions) was sent to all members of the Italian Society of Radiology two months after the first Italian national lockdown was lifted.ResultsA total of 327 Italian radiologists took part in the survey (mean age: 49 ± 12 years). After national lockdown, the working-flow came back to normal in the vast majority of cases (285/327, 87.2%). Participants reported that a total of 462 radiological trials were recruiting patients at their institutions prior to COVID-19 outbreak, of which 332 (71.9%) were stopped during the emergency. On the other hand, 252 radiological trials have been started during the pandemic, of which 156 were non-COVID-19 trials (61.9%) and 96 were focused on COVID-19 patients (38.2%). The majority of radiologists surveyed (61.5%) do not conduct research. Of the radiologists who carried on research activities, participants reported a significant increase of the number of hours per week spent for research purposes during national lockdown (mean 4.5 ± 8.9 h during lockdown vs. 3.3 ± 6.8 h before lockdown; p = .046), followed by a significant drop after the lockdown was lifted (3.2 ± 6.5 h per week, p = .035). During national lockdown, 15.6% of participants started new review articles and completed old papers, 14.1% completed old works, and 8.9% started new review articles. Ninety-six surveyed radiologists (29.3%) declared to have submitted at least one article during COVID-19 emergency.ConclusionThis study shows the need to support radiology research in challenging scenarios like COVID-19 emergency.     

Retrobulbar ocular blood flow and choroidal vascular changes in patients recovering from COVID-19 infection

BackgroundTo evaluate the effects of COVID-19 infection on the ocular vascular structure including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjects.MethodsNinety eyes of 90 patients were included in this study. Participants were divided into Group 1 (n = 30) with mild COVID-19 infection, Group 2 (n = 31) with moderate disease, and Group 3 with age- and sex-matched healthy subjects (n = 29). Choroidal thickness was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm, using the enhanced depth imaging (EDI) technique of spectral coherence tomography (SD-OCT). The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography (CDU).ResultsThe choroidal thickness was significantly thinner in Group 1 and Group 2 than in Group 3 at all measurement points (p <0.001). This difference was not present between Group 1 and Group 2 who had COVID-19 disease of different severity (p>0.05).Among the retrobulbar blood flow parameters, OA PSV value was significantly lower in Group 1 and Group 2 compared to Group 3 (p = 0.025, p = 0.016, respectively). However, the CRA PSV and EDV and OA EDV values, and the CRA and OA PI and RI values were not statistically different between the groups (p> 0.05).ConclusionCOVID-19 infection may predispose patients to ocular vascular pathologies by affecting both choroidal and retrobulbar blood flow.     

MRI reporting by radiographers: Findings of an accredited postgraduate programme

AimTo analyse the objective structured examination (OSE) results of the first three cohorts of radiographers (n = 39) who completed an accredited postgraduate certificate (PgC) programme in reporting of general magnetic resonance imaging (MRI) investigations and to compare the agreement rates with those demonstrated for a small group of consultant radiologists.MethodForty MRI investigations were used in the OSE which included the following anatomical areas and abnormal appearances: knee; meniscal/ligament injuries, bone bruises, effusions and osteochondral defects; lumbar spine: intervertebral disc morphology, vertebral collapse, tumours (bone and soft tissue), spinal stenosis and/or nerve root involvement; internal auditory meati (IAM): acoustic neuroma. Incidental findings included maxillary polyp, arachnoid cyst, renal cyst, hydroureter, pleural effusion and metastases (adrenal, lung, perirenal and/or thoracic spine). Sensitivity, specificity and total percentage agreement rates were calculated for all radiographers (n = 39) using all reports (n = 1560). A small representative subgroup of reports (n = 27) was compared to the three consultant radiologists' reports which were produced when constructing the OSE. Kappa values were estimated to measure agreement in four groups: consultant radiologists only; radiographers and each of the consultant radiologists independently.ResultsThe sensitivity, specificity and agreement rates for the three cohorts (combined) of radiographers were 99.0%, 99.0% and 89.2%, respectively. For the majority (5/9) of anatomical areas and/or pathological categories no significant differences (p < 0.05) were found between the mean Kappa scores (K = 0.47–0.76) for different groups of observers, whether radiographers were included in the group analysis or not. Where differences were apparent, this was in cases (4/9) where the variation was either not greater than found between radiologists and/or of no clinical significance. These results suggest therefore that in an academic setting, these groups of radiographers have the ability to correctly identify normal investigations and are able to provide a report on the abnormal appearances to a high standard. Further work is required to confirm the clinical application of these findings.     

MRI reporting radiographers - A survey assessment of number and areas of practice within the United Kingdom

IntroductionThe aim of this study was to determine a baseline assessment of the national picture of MRI reporting radiographers within the United Kingdom.MethodA questionnaire was utilised using both open and closed questions, the twenty questions were based on four main themes of those in training, those trained, those no longer reporting and post qualification sign off and expectations. The questionnaire was sent out to multiple special interest and MRI specific groups.ResultsResponses were received from 46 trusts (n = 46) between September 2019 and May 2020. The majority of respondents were from English Trusts (n = 40/46). 31 radiographers from 21 different trusts were training in MRI reporting with the majority of those training to report thoraco-lumbar spines and knees. 80 radiographers from 38 trusts had completed training with 77 of those being trained at one south of England University. 57 radiographers from 35 trusts were in practice with the majority of these reporting thoraco-lumbar spines and knees.ConclusionThis survey provides an insight into the current status of MRI reporting radiographers in the UK. Although courses have been available since 2003, numbers are still low and there are significant geographical and working practice variations. Defined standards of practice and the implementation of a central register would benefit both those in practice and those looking to implement a MRI reporting radiographer service.Implications for practiceThis study gives some baseline evidence of the number and scope of practice of MRI reporting radiographers in the UK.     

Radiographers' commitment to continuing professional development: A single-centre evaluation

PurposeThis study aimed to examine radiographers' commitment to continuing professional development (CPD), and to ascertain what types of activities are preferred so a model for provision of departmental activities could be developed.MethodsAn online survey was used to obtain information from all departmental radiographers regarding their commitment to CPD. Statistical analysis, using Spearman's Rho and Chi-Square test, was utilised to investigate any associations.ResultsAll radiographers (n = 57) were invited via email. A response rate of 67% (n = 38) prevailed. Radiographers feel CPD is important and a positive correlation existed with feelings regarding compulsory CPD (r value = .718, P value = .001). Thirty-four percent had logged the SOR-recommended twelve or more pieces of CPD in the last 2 years. One to three hours a month is the preferred amount of own time radiographers are willing to dedicate. Negative correlations exist between the amount of own time radiographers are willing to commit to CPD activities and their feelings regarding compulsory CPD (r value = −.419, P value = .009), and HCPC audit (r value = −.509, P value .001).ConclusionAlthough radiographers recognise the importance of CPD many spend less than four hours of their own time a month on CPD. Departmental activities should be free, short lasting, lunchtime presentations with theory presentation that encourage interaction and discussion with inclusion of practical elements. Further research investigating the barriers that prevent radiographers from partaking in CPD and the causes for insufficient CPD records is recommended.     

To keep or reject,that is the question - A survey on radiologists and radiographers’ assessments of plain radiography images

IntroductionThis study aimed to survey radiographers and radiologists' assessment of plain radiographs to identify the imaging clinicians’ differences in acceptance of image quality.MethodAn online, questionnaire was distributed among radiographers (n = 116) and radiologists (n = 76) in a hospital trust in Norway, including 30 clinical cases (one image and a short referral text) that were divided into 3 categories; keep, could keep and reject, based on European guidelines. When rejecting, the respondents identified the main reason by ticking a list (positioning, collimation, centering, artifact or exposure error). Group differences were explored using 2-tailed chi-squared test. Inter-subjectivity was measured using Cohen's kappa for multi-rater sample.ResultsIn total, 36% of the radiographers (n = 42) and 14% of the radiologists (n = 14) responded to the survey. Total response rate was 30% (56/192). Analysis showed significant difference between radiographers and radiologists in the categories of Reject (χ² = 6.3, df = 1, p = 0.01), and Could keep (χ² = 6.3, df = 1, p = 0.01), identifying radiologists as keeping more images compared to radiographers. Agreement among radiographers (Cohen's κ: 0,39; 95% CI: 0.30–0.48; p < 0.001) and radiologists (Cohen's κ: 0,23; 95% CI: 0.09–0.37; p < 0.001) respectively, is fair. The most common reason for rejecting an image is suboptimal positioning. Suboptimal collimation constituted 15% of the rejected images among radiographers, compared to 5% among radiologists. Centering, artifacts and exposure error showed quite similar rates as reasons for rejection.ConclusionRadiographers and radiologists seem to agree on the assessment of good quality images, however, radiographers seem more reluctant to accept images of lower quality than radiologists.Implications for practiceFurther research on reasons for differences in image quality assessment between radiographers and radiologists is needed. This could enable reduction in reject rates and increase image quality in conventional X-ray examinations.     

Quantitative assessment of lung involvement on chest CT at admission: Impact on hypoxia and outcome in COVID-19 patients

BackgroundThe aim of this study was to quantify COVID-19 pneumonia features using CT performed at time of admission to emergency department in order to predict patients' hypoxia during the hospitalization and outcome.MethodsConsecutive chest CT performed in the emergency department between March 1st and April 7th 2020 for COVID-19 pneumonia were analyzed. The three features of pneumonia (GGO, semi-consolidation and consolidation) and the percentage of well-aerated lung were quantified using a HU threshold based software. ROC curves identified the optimal cut-off values of CT parameters to predict hypoxia worsening and hospital discharge. Multiple Cox proportional hazards regression was used to analyze the capability of CT quantitative features, demographic and clinical variables to predict the time to hospital discharge.ResultsSeventy-seven patients (median age 56-years-old, 51 men) with COVID-19 pneumonia at CT were enrolled. The quantitative features of COVID-19 pneumonia were not associated to age, sex and time-from-symptoms onset, whereas higher number of comorbidities was correlated to lower well-aerated parenchyma ratio (rho = −0.234, p = 0.04) and increased semi-consolidation ratio (rho = −0.303, p = 0.008).Well-aerated lung (≤57%), semi-consolidation (≥17%) and consolidation (≥9%) predicted worst hypoxemia during hospitalization, with moderate areas under curves (AUC 0.76, 0.75, 0.77, respectively). Multiple Cox regression identified younger age (p < 0.01), female sex (p < 0.001), longer time-from-symptoms onset (p = 0.049), semi-consolidation ≤17% (p < 0.01) and consolidation ≤13% (p = 0.03) as independent predictors of shorter time to hospital discharge.ConclusionQuantification of pneumonia features on admitting chest CT predicted hypoxia worsening during hospitalization and time to hospital discharge in COVID-19 patients.     

Radiology Imaging Volume Changes During Discrete COVID-19 Pandemic Waves: Implications for the Delta Variant of Coronavirus and Future Pandemics

PurposeThe aim of this study was to evaluate radiology imaging volumes at distinct time periods throughout the coronavirus disease 2019 (COVID-19) pandemic as a function of regional COVID-19 hospitalizations.MethodsRadiology imaging volumes and statewide COVID-19 hospitalizations were collected, and four 28-day time periods throughout the COVID-19 pandemic of 2020 were analyzed: pre–COVID-19 in January, the “first wave” of COVID-19 hospitalizations in April, the “recovery” time period in the summer of 2020 with a relative nadir of COVID-19 hospitalizations, and the “third wave” of COVID-19 hospitalizations in November. Imaging studies were categorized as inpatient, outpatient, or emergency department on the basis of patient location at the time of acquisition. A Mann-Whitney U test was performed to compare daily imaging volumes during each discrete 28-day time period.ResultsImaging volumes overall during the first wave of COVID-19 infections were 55% (11,098/20,011; P < .001) of pre–COVID-19 imaging volumes. Overall imaging volumes returned during the recovery time period to 99% (19,915/20,011; P = .725), and third-wave imaging volumes compared with the pre–COVID-19 period were significantly lower in the emergency department at 88.8% (7,951/8,955; P < .001), significantly higher for outpatients at 115.7% (8,818/7,621; P = .008), not significantly different for inpatients at 106% (3,650/3,435; P = .053), and overall unchanged when aggregated together at 102% (20,419/20,011; P = .629).ConclusionsMedical imaging rebounded after the first wave of COVID-19 hospitalizations, with relative stability of utilization over the ensuing phases of the pandemic. As widespread COVID-19 vaccination continues to occur, future surges in COVID-19 hospitalizations will likely have a negligible impact on imaging utilization.