Clinical Report: Trends in Chest CT Imaging Before, During, and After COVID-19
Overview
This study analyzed 241,217 CT examinations across 10 hospitals from 2019 to 2024, focusing on chest CT trends before, during, and after the COVID-19 pandemic. Results showed a significant increase in chest CT exams during the pandemic, with a plateau in the post-pandemic period, while patient radiation exposure remained stable or decreased due to improved dose management.
Background
Computed tomography (CT) has been pivotal in diagnosing and managing COVID-19-related chest conditions by detecting characteristic lung abnormalities. Early in the pandemic, CT imaging helped identify disease even in asymptomatic patients and monitor progression. However, the surge in CT use raised concerns about radiation exposure, especially in vulnerable populations. Prior studies documented increased CT use early in the pandemic, but long-term trends and radiation dose data remained limited.
Data Highlights
Period
Total CT Exams (Median/Month)
Chest CT Exams (Median/Month)
Chest CT Proportion (%)
Radiation Exposure (CTDIvol)
Pre-pandemic (Jan 2019–Feb 2020)
Varied (data not specified)
636 (avg/year normalized)
24.3%
Stable baseline
During pandemic (Mar 2020–May 2023)
Increased by 58.8% (2019 vs 2024)
1058.4 (avg/year normalized)
25.4% (p=0.33)
Stable, with decreasing trend for chest CT
Post-pandemic (Jun 2023–Dec 2024)
Continued increase overall
935.9 (avg/year normalized)
24.2%
Decreased for chest CT due to optimization
Key Findings
Total CT examinations increased by 58.8% from 2019 to 2024 across all body regions.
Chest CT exams rose significantly by 50% from 2019 to 2020 (p < 0.001), reflecting pandemic impact.
Post-pandemic chest CT numbers plateaued with a slight non-significant decrease (p = 0.14).
Chest CT proportion of total CT exams increased slightly from 24.3% to 25.4% during the pandemic, then stabilized.
Average patient radiation exposure (CTDIvol) remained stable overall and decreased for chest CT exams due to newer technologies and protocol optimization.
CT chest protocol usage shifted during the pandemic, with increased pulmonary embolism protocols (from 5% to 10%) and changes in thorax native and thorax–abdomen proportions.
Clinical Implications
The sustained increase and plateau in chest CT utilization highlight the ongoing clinical demand driven by COVID-19 and related respiratory conditions. Stable or reduced radiation doses demonstrate effective dose management, emphasizing the importance of continued protocol optimization and technology upgrades to minimize patient risk. Clinicians should balance diagnostic benefits with radiation safety, especially in vulnerable populations.
Conclusion
The COVID-19 pandemic led to a significant rise in chest CT imaging, which has since stabilized post-pandemic, while radiation exposure has been effectively controlled. These findings support the need for sustainable imaging practices that ensure diagnostic efficacy and patient safety.
References
Multiple sources (2020-2024) -- Role of CT in COVID-19 diagnosis and management
