Practical Challenges with Imaging Covid-19 in Brazil: Mitigation in and Beyond the Pandemic

Bernardo, Mônica O; Homayounieh, Fatemeh; Ebrahimian, Shadi; de Melo Tapajós, Juliana Santana; de Moura Carvalho, Luiz Cláudio; Varella, Ricardo; Khoury, Helen Jamil; Kalra, Mannudeep K

Computed tomography (CT) provides useful information in patients with known or suspected COVID-19 infection. However, there are substantial variations and challenges in scanner technologies and scan practices that have negative effect on the image quality and can increase radiation dose associated with CT. Objective: In this article, we present major issues and challenges with use of CT at five Brazilian CT facilities for imaging patients with known or suspected COVID-19 infection and offer specific mitigating strategies. Methods: Observational, retrospective and prospective study of five CT facilities from different states and regions of Brazil, with approval of research and ethics committees. Results: The most important issues include frequent use of CT, lack of up-to-date and efficient scanner technologies, over-scanning and patient off-centring. Mitigating strategies can include updating scanner technology and improving scan practices.