COVID-19 BSTI Statement and Guidance

COVID-19

Statement from the British Society of Thoracic Imaging (BSTI)

UPDATE: 11th March 2020

BSTI COVID-19 DATBASE

https://www.bsti.org.uk/training-and-education/covid-19-bsti-imaging-database/

Current status in the UK: 456 total cases with 6 deaths

The coronavirus outbreak has now been labelled a pandemic by the World Health Organisation. It is highly likely that the number of cases in the UK will continue to rise substantially. This will put immense pressure on hospitals and intensive care units. While the use of real time reverse-transcription polymerase chain reaction (RT-PCR) from pharyngeal swabs remains the best diagnostic test for COVID-19, its availability and turnaround times will be similarly challenged. Focus has, therefore, in some commentaries turned to the use of computed tomography (CT). BSTI have been discussing this with NHS England. The current position is that there is no recommended use of CT, beyond ‘routine clinical care’. We are reassured that this has so far also been the position taken by the American College of Radiology, in recommendations published today.

In a situation where numbers rise very rapidly, with increasingly ill patients requiring hospital admission, the role of CT may turn towards risk stratification and assessment of disease burden. Again these discussions are on-going with the Royal College of Radiologists and NHS England. We also have dialogue with our Italian colleagues. 

As such, it is vital that radiologists throughout the UK, and those that may provide services to UK patients through tele-radiology services, become familiar with the typical, indeterminate and atypical imaging features of COVID-19.

BSTI have created a UK image registry and we urge you to upload cases to this via the links on the website (https://bit.ly/BSTICovid19_Database). A data protection impact assessment form (DPIA) and FAQs are also available. Cases are auto anonymized at upload with no patient identifiers available publicly. Selected cases will be published via the ‘teaching library’ (https://bit.ly/BSTICovid19_Teaching_Library). We will also be providing a power-point presentation shortly.

Please find our previous statements here: https://www.bsti.org.uk/standards-clinical-guidelines/clinical-guidelines/covid-19-statements-archive/

Useful links:

https://pubs.rsna.org/2019-ncov

https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection

https://www.ajronline.org/doi/full/10.2214/AJR.20.22969

https://www.jacr.org/article/S1546-1440(20)30150-2/fulltext

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30086-4/fulltext

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30134-1/fulltext

https://pubs.rsna.org/doi/10.1148/radiol.2020200241

https://pubs.rsna.org/doi/10.1148/radiol.2020200230