The Role of Chest Imaging in Patient Management

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

Essentials

Imaging is not indicated in patients with suspected COVID-19 and mild clinical features unless they are at risk for disease progression.
Imaging is indicated in a patient with COVID-19 and worsening respiratory status.
In a resource-constrained environment, imaging is indicated for medical triage of patients with suspected COVID-19 who present with moderate-severe clinical features and a high pre-test probability of disease.

Methods

This Consensus Statement is based upon expert opinion amongst a panel of 15 thoracic radiologists, 10 pulmonologists/intensivists (including one anesthesiologist), and 1 pathologist, as well as additional experts in emergency medicine, infection control, and laboratory medicine. The panel included individuals from the United States, Italy, China, Germany, France, United Kingdom, Netherlands, South Korea, Canada, and Japan, representing 9 of the 15 countries with the highest number of confirmed COVID-19 cases reported worldwide as of April 1, 2020 (2). The panel possessed experience managing patients during periods of local viral amplification and critical resource constraints in Wuhan China, Northern Italy, and New York City.