The American College of Radiology has released recommendations to guide practitioners in the use of imaging to diagnose COVID-19 infections.
“To date, most of the radiologic data comes from China. Some studies suggest that chest CT in particular may be positive in the setting of a negative test. We want to emphasize that knowledge of this new condition is rapidly evolving, and not all of the published and publicly available information is complete or up-to-date.
“Key goals for the U.S. health care system in response to the COVID-19 outbreak are to reduce morbidity and mortality, minimize disease transmission, protect health care personnel, and preserve health care system functioning.
The ACR believes that the following factors should be considered regarding the use of imaging for suspected or known COVID-19 infection:
The Centers for Disease Control (CDC) does not currently recommend CXR or CT to diagnose COVID-19. Viral testing remains the only specific method of diagnosis. Confirmation with the viral test is required, even if radiologic findings are suggestive of COVID-19 on CXR or CT.
For the initial diagnostic testing for suspected COVID-19 infection, the CDC recommends collecting and testing specimens from the upper respiratory tract (nasopharyngeal AND oropharyngeal swabs) or from the lower respiratory tract when available for viral testing.
Generally, the findings on chest imaging in COVID-19 are not specific, and overlap with other infections, including influenza, H1N1, SARS and MERS. Being in the midst of the current flu season with a much higher prevalence of influenza in the U.S. than COVID-19, further limits the specificity of CT.
To read more, visit ACR.
Featured image: Transmission electron micrograph of SARS-CoV-2 virus particles, isolated from a patient. Image captured and color-enhanced at the NIAID Integrated Research Facility in Fort Detrick, Md. Courtesy National Institute of Allergy and Infectious Diseases.