ACR recommends sparing use of CT for COVID-19

CT should not be used as a first-line diagnostic or screening tool for the novel coronavirus disease (COVID-19), according to a March 11 statement by the American College of Radiology (ACR). The statement covers the appropriate use of chest x‑ray and CT for the screening, diagnosis, and management of COVID‑19.

The ACR noted that early reports from China indicated that CT could detect COVID-19, even when DNA tests were negative. But the agency further noted that new reports indicate that chest imaging findings for the disease are not specific and often overlap with other infections, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

What's more, the ACR noted that the U.S. Centers for Disease Control and Prevention currently does not recommend chest x-ray or CT to diagnose COVID-19.

The ACR's recommendations include the following:

• Clinicians should not use CT as a first-line or screening test to diagnose COVID-19.
• Clinicians should reserve CT use for hospitalized, symptomatic patients with specific clinical indications for CT.
• Facilities should apply appropriate infection control procedures when scanning patients.
• Facilities may consider using portable radiography units when x-ray is medically necessary.
• Radiologists should be familiar enough with CT findings associated with COVID-19 to be able to identify the disease.

In addition, the college suggested that facilities consider not only thoroughly cleaning medical imaging machines and devices but also suspending use of imaging rooms for roughly one hour between imaging infected patients, depending on the room's air exchange rate.