ACR COVID-19 Clinical Resources for Radiologists

The health and safety of radiologists, allied professionals, patients and health care workers are of primary importance.

To help radiology professionals make more informed decisions during the Coronavirus (COVID-19) pandemic, the ACR has collected the radiology-specific materials below. The ACR will update this page regularly, as reliable information becomes available.

The resources below are not intended to be — nor offered as — comprehensive medical guidelines, but may be of help as the radiological community works to protect patients and health care providers from this virus.

Submit coronavirus-related questions to COVID19@acr.org (only COVID-19 clinical, economic or regulatory queries - not for accreditation questions).

COVID-19 Vaccinations and Imaging Exams

Some patients who receive COVID-19 vaccinations may temporarily develop benign swollen lymph nodes, which can show up on mammograms and other imaging tests.

Though it is optimal for a patient to have needed imaging (screening or diagnostic) prior to COVID-19 vaccination, the resources below may be helpful when caring for recently vaccinated patients.

  • The Society of Breast Imaging® (SBI) has offered guidance for radiology providers  with this introduction: 

    "The management approach to unilateral axillary adenopathy in patients who recently received a COVID-19 vaccine is based at this point on expert consensus opinion. The Society of Breast Imaging recognizes that there are a variety of valid approaches to this clinical situation. Our approach is by design a conservative one, which stresses an abundance of caution. Individual practices may wish to develop their own guidelines based on their expertise, local resources, and institutional support. Consider seeking agreement from all practice members so there are consistent recommendations to patients and referring providers. The SBI will continue to reassess our recommendations as new evidence becomes available."

  • Researchers from Massachusetts General Hospital recently released breast imaging guidance .
  • An article published  in JACR® by MGH  researchers offers steps to help providers properly diagnose such patients undergoing a broad range of imaging exams and reduce unwarranted follow-up care.
  • On April 13, the CDC issued a Health Alert  through the Health Alert Network (HAN): “Cases of Cerebral Venous Sinus Thrombosis with Thrombocytopenia after Receipt of the Johnson & Johnson COVID-19 Vaccine” about the identification of six cases of CVST, a rare and severe thrombotic event. The American Society of Hematology has also released “Immune Thrombotic Thrombocytopenia: Frequently Asked Questions .”


Resumption of Non-Urgent Care

HHS Extends Public Health Emergency Declaration  
On Oct. 2, U.S. Secretary of Health and Human Services (HHS), Alex Azar, renewed the public health emergency (PHE) declaration due to the ongoing COVID-19 pandemic. Effective Oct. 23, 2020 (the date the PHE was set to expire), the declaration will be extended for another 90 days. PHE status has allowed necessary flexibilities and protections to physicians during this time when patients need access to care. The extension has several policy implications regarding telehealth and other Medicare policies that are dependent on the state of a PHE. This is the third time that the PHE declaration has been extended.

SNMMI Releases Updated Statement: COVID-19 and Ventilation/Perfusion (V/Q) Lung Studies 
Reflecting global geographic differences in COVID-19 pandemic evolution, the Society of Nuclear Medicine and Molecular Imaging (SNMMI) has released an updated statement regarding concerns about ventilation/perfusion (V/Q) lung scans ‒ specifically, the inherent risk of spread of COVID-19 to patients and staff related to the ventilation portion of this study. This latest statement is an update to SNMMI’s March 19 statement on this issue.

Radiologist house-call program helps drop ED visits, improve patient satisfaction 
A novel house-call program in Indiana helped drop emergency department visits by 77% and hospital readmissions by 50%, with patient satisfaction scores soaring. Experts detailed the findings of this study on a population of more than 1,000 seniors during the Society of Interventional Radiology’s virtual meeting on Saturday.

CMS Issues Guidelines to Help Healthcare Facilities Reopen 
The Centers for Medicare & Medicaid Services (CMS) has released a guide  to help ensure that non-emergency healthcare resumes safely and that patients are receiving needed in-person treatment that may have been postponed due to the public health emergency.

AMA resources help doctors navigate state reopening rules 
The American Medical Association’s advocacy arm has released a fact sheet to help doctors make reopening plans consistent with the regulations. As the fact sheet notes, guidelines released by the Centers for Medicare and Medicaid Services ultimately put these decisions in the domain of state and local governments.

Free May 28 Webinar - COVID Recovery: Practice Management Post-Pandemic 
A free JACR-sponsored webinar brings together leaders from throughout the specialty to discuss how to move forward in the aftermath of the pandemic.

States With Elective Medical Procedures Guidance in Effect
Following the Trump Administration’s “Opening Up America Again ” guidelines and CMS “Recommendations to Re-Open Health Care Systems in Areas with Low Incidence of COVID-19 ,” ACR consultant Todd Strategies has provided this summary of actions that 38 state governments have taken regarding resumption of non-urgent and elective procedures.

COVID-19 Pandemic Breast Cancer Consortium’s Considerations for Re-entry
The ACR and several other medical societies released joint guidelines regarding offers recommendations on how sites can safely resume the multidisciplinary care of breast cancer patients whose treatment has been put on hold or otherwise modified during the COVID-19 pandemic.

New ACR Guidance Can Help Radiology Facilities Resume Non-Urgent Care  
American College of Radiology® (ACR®) guidelines published today in the Journal of the American College of Radiology can help radiology practices, as safely as possible, resume offering mammograms, oncologic and orthopedic imaging, image-guided biopsies, and other non-urgent care previously postponed due to the COVID-19 pandemic.

Free ACR® Webinar: What Might Your Practice Look Like Post-Peak COVID-19? 
Expert speakers discuss major changes they anticipate to their diverse radiology business and practice models, following the expected COVID-19 peak.

Society of Breast Imaging (SBI) - SBI Recommendations for a Thoughtful Return to Caring for Patients 

The Resumption of Lung Cancer Screening Quick Reference Guide
A one-page document informing patients and providers about the changes made to screening procedures/sites during the pandemic.

Telehealth Quick Reference Guide
A one-page document providing a quick reference for telehealth guidelines and resources for shared decision making.

Template Letters
Template letters for both patients and referring providers informing them of updated procedures and precautions due to the COVID-19 pandemic. These letters can be used and updated with your letter head.
Template 1 - Reassurance Letter
Template 2 - Return to Screening Letter
Template 3 - Postponed Screening Letter
Template 4 - Referring Provider Letter

Patient Safety Infographic [English] 
Patient Safety Infographic [Español]
Show patients what they can expect when scheduling their imaging and how you will keep them safe.

 

Rescheduling Non-Urgent Care

The ACR fully supports and recommends compliance with the Centers for Disease Control and Prevention (CDC) guidance that advises medical facilities to “reschedule non-urgent outpatient visits.” This includes non-urgent imaging and fluoroscopy procedures, including but not limited to: screening mammography, lung cancer screening, non-urgent computed tomography (CT), ultrasound, plain film X-ray exams, magnetic resonance imaging (MRI) and other non-emergent or elective radiologic and radiologically guided exams and procedures. Radiologists should work with their referring physicians to review and reschedule such exams.

U.S. Food & Drug Administration - MQSA Inspection Information Related to COVID-19
The FDA has provided this guidance for imaging facilities that close or cease screening mammography exams during this COVID-19 time period.

 

COVID-19 Diagnosis

Radiology: A Characteristic Chest Radiographic Pattern in the Setting of COVID-19 Pandemic 

ACR Statement on Use of Computed Tomography (CT) and Radiography for Suspected COVID-19 Infection

The Fleischner Society - Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement   

Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19.  Endorsed by the Society of Thoracic Radiology, ACR and RSNA

Canadian Society of Thoracic Radiology and the Canadian Association of Radiologists’ Statement on COVID -19 

Royal Australian and New Zealand College of Radiologists - COVID-19 Essential Role of Clinical Radiology Services 

(UK) Royal College of Radiologists position on the role of CT in patients suspected with COVID-19 infection 

Society for Advanced Body Imaging (SABI) Webinar – COVID-19: Thoracic Imaging Findings and Recommendations 

 

Radiology Provider and Patient Safety

 

Centers for Medicare & Medicaid Services (CMS) Resources

CMS Updates QPP Relief Guidance  
 CMS has released an updated COVID Response Factsheet for physicians participating in the 2019 Merit-based Incentive Payment System (MIPS) pathway of the Quality Payment Program (QPP). This factsheet details relief efforts for QPP-eligible clinicians including an extension of the MIPS data submission deadline, as well as the opportunity for automatic exemption from the program.

 

Research

 

Interventional Radiology Resources

Society of Interventional Radiology COVID-19 Toolkit 
The SIR has released a toolkit of information and guidance to help interventional radiologists to plan for the management of COVID-19 patients.

 

Radiation Oncology Resources

 

Breast Imaging

The ACR is offering a few common sense suggestions that may help breast imaging providers decrease risk of COVID-19 transmission in their facilities.

Concepts to remember:

  • Social distancing — keeping at least six feet between individuals in waiting rooms and work spaces as much as feasible
  • Strict adherence to cleaning and disinfecting equipment
  • Technologist and radiologist hand washing
  • Increasing scheduling intervals or appointment times to allow adequate time to clean equipment as needed

The ACR will keep members informed regarding future relevant actions that the medical and radiological communities may take that could help protect patients and providers from the Coronavirus.

ACR Bulletin, ACR Data Science Institute, JACR, Radiology Leadership Institute, and National Radiology Data Registry Resources

 

Peer-to-Peer Information 

Trainee and Attending Perspectives on Remote Radiology Readouts in the Era of the COVID-19 Pandemic 

Radiologist Discusses How to Stop COVID-19 Spread on Popular Medical Podcast 

Free Residency Training Resources

The ACR is here to support radiology residency programs during the COVID-19 outbreak with free online Residency Training Resources.

 

Case In Point (CIP) COVID-19 Cases

The ACR offers Case In Point COVID-19 cases  for CME and non-CME open access.

 

Radiology-TEACHES COVID-19 Module

An introduction to COVID-19 and the use of radiology for diagnosis specifically created for medical students. Cases and imaging examples are included to help medical students understand the role of radiology and the feature of COVID-19.

Other Medical Articles and Collections

 

Recommended Resources

Centers for Disease Control and Prevention

World Health Organization

 

Health Care Specialty Groups COVID-19 Resource Sites

COVID-19 Economic and Regulatory Updates

CapHillAchievements_320

New laws offer financial relief to radiology practices economically impacted by the COVID-19 pandemic. Stay informed of the latest legislative and regulatory developments. (login required)

Access Economic Updates »