Observational studyEuropean radiology2026
Computed tomography pulmonary angiography in around-the-clock clinical care with individualised scan protocols: a 5-year observational study on incidence and causes of repeat scanning.
Observational study in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
objectivesElevated repeat-scanning rates are reported for CT pulmonary angiography (CTPA). Individualised protocols optimise contrast- and radiation-doses, but whether this affects repeat scanning is unknown. The current study evaluates repeat-CTPA in a 24/7, state-of-the-art clinical-care setting. MATERIALS AND
methodsThis is a retrospective observational single-centre study of consecutive CTPA acquired over a 5-year period during standard clinical care. The primary outcome is the repeat-scan rate. Repeat- and single-scan groups were compared for initial-scan characteristics (patient-related, CT-scanner, contrast-administration, kV-settings, regular hours/shifts, radiation-dose), and cumulative contrast- and radiation-doses. An expert radiologist panel retrospectively evaluated probable reasons for repeat scanning through visual, subjective assessment of initial-scan images.
resultsCTPA repeat rate was 3.1% (139/4467). Repeat- and single-scan groups significantly differed: age (55 ± 18 vs. 63 ± 17 years; p < 0.001), Body Mass Index (27 kg/m
conclusionIndividualised scan protocols yielded diagnostic images around the clock, with repeat scanning well within ranges published in the literature. Retrospective expert evaluation suggests repeat rates as low as 1.2% may be possible. Repeat- and single-scan groups significantly differed in patient characteristics, and repeat-scanning reasons were mostly patient-related. These results suggest further tailoring protocols to (younger, female) patients might be beneficial in helping to further reduce CTPA-repeats. KEY POINTS: Question CT pulmonary angiography (CTPA) is subject to relatively high repeat-scanning rates, but it is not known how state-of-the-art CTPA and individualised protocols perform in clinical practice today. Findings During 5 years of clinical practice the repeat rate was 3%; retrospective expert image-evaluation suggests a repeat rate as low as 1.2% may be possible. Clinical relevance Repeat- and single-scan groups significantly differed in patient characteristics, and reasons for repeat scanning were mostly patient-related. Further tailoring protocols to (younger, female) patients may be the best focus to help reduce CTPA-repeats, improve safety, and reduce logistic burden.
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