CT in adult patients with Polytrauma: current practices, protocol optimization, structured reporting and future...

Area of Science:

• Radiology
• Medical Imaging
• Trauma Care

Background:

• Computed tomography (CT) is the primary imaging tool for polytrauma patients.
• Whole-body CT (WB-CT) offers speed and accuracy but faces debates on patient selection, protocols, and radiation.
• WB-CT improves diagnosis time and injury detection compared to selective CT, though mortality benefits vary.

Purpose of the Study:

• To review current guidelines and compare WB-CT with selective CT.
• To discuss existing WB-CT protocols and propose an optimized protocol (IMPACT Protocol).
• To provide recommendations for structured reporting and future implementation of WB-CT in trauma.

Main Methods:

• Review of current literature and guidelines on WB-CT in polytrauma.
• Comparison of WB-CT versus region-specific selective CT.
• Proposal of the 'IMPACT Protocol' (Integrated Multiphase Polytrauma Assessment CT).

Main Results:

• WB-CT shortens time-to-diagnosis and enhances injury detection.
• Newer protocols (split-bolus, DECT, dose-reduced) aim to optimize accuracy while minimizing radiation and contrast.
• Structured reporting and AI tools show potential for improving workflow efficiency and diagnostic performance.

Conclusions:

• WB-CT is a valuable tool in polytrauma management, with ongoing efforts to optimize its use.
• The proposed IMPACT Protocol offers a practical approach to WB-CT optimization.
• Structured reporting and AI integration are key for future advancements in trauma CT workflows.