COVID-19 HAS EXPANDED THE NEED FOR DIGITAL RADIOGRAPHY DR. ROSHAN JOHN KOSHY
The current pandemic has to a large extent changed the way we currently live, into an almost online experience. In countries most impacted by Covid19, noncritical surgeries and procedures have been postponed or delayed and medical professionals redeployed to help tackle the pandemic.
Even before the pandemic, diagnostic services were already burdened by a high demand with an initial decrease in the imaging volume during the initial peak of Covid19, subsequently healthcare facilities and the radiology department in particular have been tested with larger volumes of imaging, both Covid and noncovid with resultant stress on the radiology department and its staff. This can be overcome through a large extent by expanding the need for digital radiography.
Even though the basic modality of radiology (i.e.) Xrays have taken a path towards digitalization a while ago, the current pandemic has reiterated the need for speedy workflow and patient management with less than one minute between exposure and image acquisition. In addition to the turn around time, digital radiography also has the advantage of lower radiation exposure to both patient and technologist, and this augurs well also for patients who require sequential imaging. The demand for portable Xrays has increased in view of the ease in acquiring digital Xrays in an ICU or isolated room setting without having to shift the patient to the radiology department. This overcomes location barriers, minimizes the risk of crossinfection related to patient transport and benefits the patient and doctors with images being available online for early diagnosis.
In developing countries, the DR systems are commonly used to arrive at a diagnosis of Covid related lung changes due to their affordability over CT systems. Moreover, the time required for a CT scan room to be decontaminated and sterilized after imaging a Covid19 patient puts pressure on time and resources. In future, if there is a situation like the current pandemic, the focus maybe a DR system with antimicrobial coatings that will help in the ease of sterilization. At the same time, it has been noted that radiology technologists have also gotten creative by innovating newer techniques while keeping staff safe. For example, shooting Xrays through a glass partition that separates the patient from the technologists. This approach was validated by a paper published in Radiography which showed that there was no significant difference in radiation dose nor any difference in image quality. This method also resulted in better workflow and productivity with time saved on cleaning the Xray systems, disinfecting the mobile detector stand and putting on and removing the PPE.
It is equally important that in the current scenario where the focus on the staff is to have least exposure to the patient, the equipment must be quick and easy to use so that the images are consistent even under stressful conditions for less experienced technologists. These images acquired can be interpreted almost in realtime, thus helping save precious treatment time. Soon, artificial intelligence (AI) is forecast to play a major role in developing bespoke solutions to similar situations; this will enable early localization and characterization of lesions and in turn empower technologists, radiologists and clinicians towards the right treatment decision. In fact, a study in review at the Journal of Medical Internet Research shows that the Covid19 pandemic is accelerating the pace and adoption of technologies such as AI. Thus, overall, the Covid 19 pandemic has expanded the need for Digital radiography like never before.