Radiologist Approval for CTPA in the ED: A Single-Centre Pilot Study Did Not Demonstrate a Statistically Significant
1Emergency Department, Nepean Hospital, Kingswood, New South Wales, Australia.
Emergency Medicine Australasia : EMA
|February 18, 2026
Summary
Removing radiologist approval for CT Pulmonary Angiography (CTPA) did not significantly impact diagnostic yield in this pilot study. This suggests vetting may not be necessary for reducing unnecessary CTPA scans.
Area of Science:
- Emergency Medicine
- Radiology
- Diagnostic Imaging
Background:
- Overutilization of CT Pulmonary Angiography (CTPA) is a persistent issue in emergency departments.
- Radiologist vetting is a strategy employed to mitigate unnecessary CTPA examinations.
Purpose of the Study:
- To evaluate the impact of implementing radiologist vetting on the diagnostic yield of CTPA.
- To determine if removing pre-authorization for CTPA affects the rate of positive findings.
Main Methods:
- A retrospective study design was utilized.
- CTPA diagnostic yields were compared between periods with and without radiologist vetting.
Main Results:
- No statistically significant difference in CTPA diagnostic yield was observed between the two groups (11.4% vs. 10.2%, p=0.60).
- The data indicates that the rate of clinically significant findings remained consistent regardless of vetting status.
Conclusions:
- Eliminating radiologist approval for CTPA did not lead to a reduction in its diagnostic yield.
- These findings suggest that radiologist vetting may not be essential for maintaining the diagnostic value of CTPA in emergency settings.
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