Diagnosing acute pulmonary embolism with computed tomography: imaging update.

Area of Science:

• Radiology
• Diagnostic Imaging
• Cardiopulmonary Medicine

Background:

• Acute pulmonary embolism (PE) presents diagnostic challenges, with high mortality if missed.
• Increasing imaging referrals and decreasing diagnostic yields for PE are significant concerns.
• Computed tomography pulmonary angiography (CTPA) is the primary imaging modality for suspected PE in emergency departments.

Purpose of the Study:

• To review recent literature on optimizing computed tomography pulmonary angiography (CTPA) for diagnosing acute pulmonary embolism (PE).
• To discuss patient selection, image quality, radiation dose, and specific patient subgroups.
• To explore the role of CTPA beyond diagnosis and emerging imaging techniques.

Main Methods:

• Literature review of recent studies on CTPA for pulmonary embolism.
• Analysis of patient selection criteria and imaging protocols.
• Discussion of advanced CT techniques and their applications.

Main Results:

• Key aspects of patient selection for CTPA are highlighted.
• Strategies for optimizing CTPA image quality and minimizing radiation dose are presented.
• The utility of CTPA in specific populations (e.g., pregnant patients) and its role in follow-up are examined.

Conclusions:

• Optimizing CTPA protocols and patient selection are crucial for accurate and efficient PE diagnosis.
• Emerging techniques like dual-energy CT and single-photon emission CT offer potential advancements.
• Radiology plays a pivotal role in the diagnostic pathway for patients with suspected pulmonary embolism.