Brigham and Women's Hospitals

For Radiologists

For Radiologists

Radiology Reporting Guidelines

  1. Thoracic Imaging
  1. Impression: Typical findings of COVID-19
  1. If COVID-19 is already confirmed
  1. State that findings are “consistent with COVID-19”.
  2. Insert Certainty Scale at the bottom the report (powerscribe shortcut is type cs and press enter). (Hammer, JACR, 2020)
  1. If COVID-19 is clinically suspected
  1. State findings “may represent viral infection such as COVID-19”. Remember to include any other differential diagnoses, as appropriate, again using certainty terms.
  2. Use Orange ANCR (page) alert for closed loop communication with responsible or ordering provider.
  3. Insert Certainty Scale at the bottom the report (powerscribe shortcut is type cs and press enter). (Hammer, JACR, 2020)
  1. Suggested additional Reporting Language: “Commonly reported imaging features of (COVID-19) pneumonia are present. Other processes such as influenza pneumonia and organizing pneumonia, as can be seen with drug toxicity and connective tissue disease, can cause a similar imaging pattern.” (Simpson, RSNA, 2020)
  1. If COVID-19 is clinically unsuspected
  1. Use Red ANCR (page) for closed loop communication with responsible or ordering provider. If after discussion with ordering/responsible provider COVID-19 becomes a possible diagnosis, you should mention COVID-19 specifically in your report using relevant certainty terms.
  2. Inform referring provider that you will contact Brigham Biothreats by paging 30331. This will initiate actions required by PHS/BH policy for COVID-19.
  3. Send purple alert page (or page) to Tyler Martin or Patrick Curley to initiate necessary radiology departmental processes for COVID-19.
  4. State findings “may represent viral infection such as COVID-19” (Hammer JACR 2020). Remember to include other clinically relevant differential diagnoses in your impression.
  1. Suggested additional Reporting Language: “Commonly reported imaging features of (COVID-19) pneumonia are present. Other processes such as influenza pneumonia and organizing pneumonia, as can be seen with drug toxicity and connective tissue disease, can cause a similar imaging pattern.” (Simpson, RSNA, 2020)
  2. Insert Certainty Scale at the bottom the report (powerscribe shortcut is type cs and press enter).
  1. If the imaging findings are that of a viral pneumonia but not typical for COVID-19, you simply report that “findings may/likely represent a viral pneumonia.”
  1. Suggested additional reporting language: “Imaging features can be seen with (COVID-19) pneumonia, though are nonspecific and can occur with a variety of infectious and noninfectious processes.” (Simpson, RSNA, 2020)
  2. If you have any questions about whether findings may represent COVID-19, you can consult thoracic radiology attending on call (or the reading room during the day). Consider using COVID-19 Consult option which has been set up in Worth Another Look (please page)
  1. DO NOT INCLUDE COVID-19 in your findings or impression other than scenarios 1-3 described above and be mindful that the absence of findings on imaging including Chest CT does not exclude COVID-19 infection. (Hammer, JACR, 2020)