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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jun 28, 2021; 13(6): 171-191
Published online Jun 28, 2021. doi: 10.4329/wjr.v13.i6.171
COVID-19 imaging: Diagnostic approaches, challenges, and evolving advances
Dante L Pezzutti, Vibhor Wadhwa, Mina S Makary
Dante L Pezzutti, Mina S Makary, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Vibhor Wadhwa, Department of Radiology, Weill Cornell Medical Center, New York City, NY 10065, United States
Author contributions: Pezzutti DL, Wadhwa V, and Makary MS performed the literature review, wrote the manuscript, prepared the figures and tables, made the requested revisions, and provided final approval of the final version of the manuscript to be published.
Conflict-of-interest statement: The authors have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mina S Makary, MD, Assistant Professor, Attending Doctor, Director, Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave, 4th Floor, Columbus, OH 43210, United States. mina.makary@osumc.edu
Received: February 7, 2021
Peer-review started: February 7, 2021
First decision: May 6, 2021
Revised: May 15, 2021
Accepted: June 23, 2021
Article in press: June 23, 2021
Published online: June 28, 2021
Abstract

The role of radiology and the radiologist have evolved throughout the coronavirus disease-2019 (COVID-19) pandemic. Early on, chest computed tomography was used for screening and diagnosis of COVID-19; however, it is now indicated for high-risk patients, those with severe disease, or in areas where polymerase chain reaction testing is sparsely available. Chest radiography is now utilized mainly for monitoring disease progression in hospitalized patients showing signs of worsening clinical status. Additionally, many challenges at the operational level have been overcome within the field of radiology throughout the COVID-19 pandemic. The use of teleradiology and virtual care clinics greatly enhanced our ability to socially distance and both are likely to remain important mediums for diagnostic imaging delivery and patient care. Opportunities to better utilize of imaging for detection of extrapulmonary manifestations and complications of COVID-19 disease will continue to arise as a more detailed understanding of the pathophysiology of the virus continues to be uncovered and identification of predisposing risk factors for complication development continue to be better understood. Furthermore, unidentified advancements in areas such as standardized imaging reporting, point-of-care ultrasound, and artificial intelligence offer exciting discovery pathways that will inevitably lead to improved care for patients with COVID-19.

Keywords: COVID-19, Coronavirus, Pandemic, Diagnostic imaging, Radiography, Computed tomography, Outcomes, Future trends

Core Tip: The role of both radiology and the radiologist has evolved throughout the coronavirus disease-2019 (COVID-19) pandemic. Detecting extrapulmonary manifestations as well as complications of COVID-19 disease with imaging remain important areas for further research. The development of COVID-19 severity scoring systems and standardized reporting methods has begun to lay the foundations for artificial intelligence systems. Furthermore, teleradiology and virtual care clinics were important components of the response to the COVID-19 pandemic and will remain important mediums for diagnostic imaging delivery and patient care. Finally, the emergence of point of care ultrasound is an exciting yet underexplored area of imaging applications for COVID-19.