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Clinical assessment before PET/computed tomography: frequency and diagnostic impact.

Mohammed A M Alqahtani¹, Yuki Arita^2,3, Walter Noordzij⁴

¹Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, The Netherlands.

Nuclear Medicine Communications

|June 15, 2026

Summary

Many patients referred for PET/CT scans miss crucial history taking and physical exams. However, this omission did not impact clinical reasoning or diagnostic yield in this study.

Keywords:

PET/computed tomography clinical reasoning history taking physical examination referral and consultation

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Area of Science:

Radiology and Nuclear Medicine
Clinical Practice Assessment

Background:

Referring physicians often do not perform history taking or physical examinations before ordering PET/CT scans.
The impact of omitting these clinical assessments on the quality of clinical reasoning and diagnostic yield of PET/CT is not well understood.

Purpose of the Study:

To determine the frequency of history taking and physical examination omissions before PET/CT referrals.
To assess whether these omissions affect clinical reasoning quality or PET/CT diagnostic yield.

Main Methods:

A study involving 288 patients undergoing PET/CT at a tertiary academic hospital.
Patients reported whether history taking and physical examination were performed by referring physicians.
Multivariable regression analyzed the association between omitted assessments and clinical reasoning quality or PET/CT positivity.

Main Results:

History taking was omitted in 18.2% of referrals, and physical examination in 47.7%.
Omission of history taking or physical examination was not significantly associated with clinical reasoning quality or PET/CT positivity.
Certain specialties and referral types showed significant associations with the performance of physical examinations.

Conclusions:

A significant proportion of patients referred for PET/CT do not undergo prior history taking or physical examination.
While omissions did not affect clinical reasoning or PET/CT yield in this study, they may reduce contextual information for image interpretation.