RCR advice on non-urgent and cancer imaging during the coronavirus pandemic

Monday 30 March 2020

This statement is archived.

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  • Routine hospital attendances for patients should be stopped to reduce COVID-19 transmission. National specialty guidance advises against routine outpatient work where possible.
  • Departments should plan to minimise non-urgent imaging as they will have fewer staff available and more demand for in-patient services.

Postponing imaging for groups of patients until after the pandemic

  • A local decision to postpone imaging for a certain group of patients should only be made in conjunction with referring clinicians and Trust management.
  • This decision should be recorded by the radiology department in a specific register as a decision taken during the pandemic.

Postponing imaging for individual patients until after the pandemic

  • Justification of the decision to postpone each imaging procedure should be recorded on the Radiology Information System (RIS).
  • Imaging postponed due to COVID-19 should be coded appropriately.
  • The referrer should be informed of the decision to postpone imaging.
  • The patient should be informed of the decision to postpone imaging and who to contact in case of concerns.
  • Patients should be advised that a further appointment for their test, if still indicated, will be sent after the pandemic has passed.

Imaging for cancer diagnosis and staging

  • Local cancer MDTs should agree appropriate diagnostic and staging imaging pathways with their MDT radiologists.
  • As these will be subject to change, MDTs should reconsider these pathways on a weekly basis and record any changes.
  • MDTs should consider:
  • National specialist society guidance if available.
  • Locally available imaging techniques.
  • Availability of treatment options – will imaging change treatment?
  • Likely yield – which tests can be omitted?

Imaging for cancer treatment and follow up

  • Imaging to assess response to treatment should be reviewed on an individual basis to see if it can be avoided or delayed. It should be avoided if response can be assessed in other ways (e.g. symptoms, blood tests).
  • If imaging is required to assess response, request the simplest test possible (e.g. CXR not CT chest where appropriate).
  • Routine cancer follow-up imaging in the absence of new symptoms should be delayed.
  • Radiology departments should agree pathways for imaging cancer patients with new symptoms with referring teams.

Re-booking patients after the pandemic

  • This will be a lengthy and complex process.
  • Careful recording of all patients and patient groups with imaging postponed should ensure patients receive any required imaging test requested once the pandemic has passed.

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