COVID-19 Pandemic-Associated Changes in the Acuity of Brain MRI Findings: A Secondary Analysis of Reports Using Natural Language Processing

Taejin L. Min, Liyan Xu, Jinho D. Choi, Ranliang Hu, Jason W. Allen, Christopher Reeves, Derek Hsu, Richard Duszak, Jeffrey Switchenko, Gelareh Sadigh


Rationale and Objectives: We aimed to assess early COVID-19 pandemic-associated changes in brain MRI examination frequency and acuity of imaging findings acuity.

Methods: Using a natural language processing model, we retrospectively categorized reported findings of 12,346 brain MRI examinations performed during 6- month pre-pandemic and early pandemic time periods across a large metropolitan health system into 3 acuity levels: (1) normal or near normal; (2) incidental or chronic findings not requiring a management change; and (3) new or progressive findings requiring a management change. Brain MRI frequency and imaging finding acuity level were compared over time.

Results: Between March and August of 2019 (pre-pandemic) and 2020 (early pandemic), our health system brain MRI examination volumes decreased 17.0% (6745 vs 5601). Comparing calendar-matched 6-month periods, the proportion of higher acuity findings increased significantly (P< 0.001) from pre-pandemic (22.5%, 43.6% and 34.0% in acuity level 1, 2, and 3, respectively) to early pandemic periods (19.1%, 40.9%, and 40.1%). During the second 3 months of the early pandemic period, as MRI volumes recovered to near baseline, the proportion of higher acuity findings remained high (42.6% vs 34.1%) compared with a similar pre-pandemic period. In a multivariable analysis, Black (B coefficient, 0.16) and underinsured population (B coefficient, 0.33) presented with higher acuity find- ings (P< 0.05).

Conclusions: As the volume of brain MRI examinations decreased during the early COVID-19 pandemic, the relative proportion of examinations with higher acu- ity findings increased significantly. Pandemic-related changes in patient outcomes related to reduced imaging access merits further attention.Venue / Year

Current Problems in Diagnostic Radiology (CPDR) / 2021


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