As of this date, a pre-op CT chest does not add to the detection of COVID-19 in asymptomatic, isolated and tested patients and is not recommended for screening before elective cancer surgery.
Please see the Guidelines for pre-operative COVID-19 testing for elective cancer surgery (PDF). This document updates the previous intercollegiate guidance (15 April 2020).
Routine pre-operative chest CT to screen for COVID-19 is NOT indicated
The relatively low pick up rate of COVID-19 in asymptomatic patients with positive RT-PCR and a 20% false negative rate in symptomatic patients indicates that pre-operative CT chest is of limited utility.
Routine COVID-19 precautions are recommended: negative RT-PCR within 48 hours, no symptoms for seven days and self-isolation for 14 days.
If, despite a negative swab and patient isolation, there is still concern about possible COVID-19 infection in asymptomatic patients, there should be discussion between the clinical team and the duty radiologist to determine whether further imaging is justified. Consideration should be given to local disease prevalence but pre-operative CT chest should be not be performed unless a positive scan means the operation would be postponed.
Requests for routine scanning of pre-operative patients will be rejected.
There are significant implications on scanner capacity which is required to scan urgent patients and elective patients whose imaging has been delayed due to the COVID-19 crisis.
This statement replaces the previous 30 April 2020 statement on the role of CT in screening elective pre-operative patients
See additional RCR statements on the role of CT chest:
- 26 June 2020: The role of CT chest in patients presenting acutely and requiring an abdominal CT
- 27 March 2020: The role of CT chest in patients presenting acutely and requiring an abdominal CT
- 12 March 2020: The role of CT in patients suspected with COVID-19 infection