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

Abstract 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 three 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% (6,745 vs. 5,601). Comparing calendar-matched 6-month periods, the proportion of higher acuity findings increased significantly (p Conclusion As the volume of brain MRI examinations decreased during the early COVID-19 pandemic, the relative proportion of examinations with higher acuity findings increased significantly. Pandemic-related changes in patient outcomes related to reduced imaging access merits further attention.