A review of the effectiveness of fever tent setup in COVID-19 pandemic from a radiology perspective.

INTRODUCTION: This paper describes our experience in setting up a dedicated imaging facility within a temporary fever tentage in an acute tertiary hospital in Singapore during the coronavirus disease 2019 (COVID-19) pandemic. We review the effectiveness of the setup and its role from the radiological perspective in detail. METHODS: The dedicated imaging facility within the temporary fever tentage was equipped with a computer-on-wheels (COWs) to access patients' medical records and a portable x-ray machine to allow for a smooth workflow. Radiation dose measurements were acquired around the imaging facility using phantoms and dosimeters to ensure radiation safety. RESULTS: Due to its rapid nature and availability as a screening tool, chest x-ray (CXR) is the most widely used imaging modality during the COVID-19 pandemic. Our dedicated fever tent setup minimizes possible in-hospital transmission between both patients and staff and provides a more streamlined workflow to tackle the high workload. It allowed us to reduce the time required for each radiograph, providing timely imaging services and radiological reports for expedient clinical screening. DISCUSSION: The close collaboration between Radiology and Emergency Departments in setting up the fever tentage is a crucial tool in managing the COVID-19 pandemic. The fever tentage imaging facility is a highly effective tool, providing the means to handle the increased patient load in a streamlined and safe manner during a pandemic. CONCLUSION: This paper provides insights and guidelines in setting up a dedicated imaging service within the fever tent for future infectious disease outbreak contingency plans.

The efficacy of tin-filtration for computed tomography in diagnosing urolithiasis.

INTRODUCTION: The purpose of this study was to evaluate the radiation dose and image quality of computed tomography urograms (CTU) using tin-filtration compared to conventional CTU (without tin-filtration) examinations in patients with suspected urolithiasis. METHODS: Group 1 consisted of 100 patients who were examined using the tin-filtered CTU protocols (Sn100kVp or Sn150kVp); Group 2 consisted of 100 patients who were examined using the same protocols but without tin-filtration (GE-NI41 or GE-NI43). The scanning protocol was based on the patients' body weight (<80 kg and ≥80 kg). The effective doses of all scans were compared between the two groups. Subjective image quality was evaluated by two blinded radiologists. The objective image quality was assessed for noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and figure-of-merit (FOM) using the CTU scans acquired from both the tin-filtered and non-tin-filtered protocols. RESULTS: Tin-filtration resulted in the reduction of effective radiation dose ranging between 72% to 88% for the ≥80 kg and <80 kg patient groups respectively. For both groups, tin-filtration resulted in no significant differences in SNR and a significant increase in FOM. For the <80 kg group, tin-filtration resulted in significantly noisier images but with no significant difference in CNR. For the ≥80 kg group, tin-filtration resulted in significantly higher CNR. There was no significant difference in subjective image quality when assessed by the radiologists in terms of diagnostic confidence for urolithiasis. CONCLUSION: Tin-filtration significantly reduces patient dose while maintaining diagnostic image quality of CTUs for patients with suspected urolithiasis.