ArticleEmergency radiology2026
Beyond the clot: diagnostic yield, biomarker performance, and the landscape of alternative diagnoses in emergency CT pulmonary angiography.
Article in Emergency radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Beyond diagnostic yield: do alternative findings justify CT pulmonary angiography?Emergency radiology · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComputed Tomography Pulmonary Angiography (CTPA) is the gold standard for diagnosing acute Pulmonary Embolism (PE). However, overlapping symptoms and reliance on non-specific biomarkers often lead to over-testing. This study provides a comprehensive analysis of CTPA utilization, evaluating diagnostic yield, biomarker performance, and the landscape of alternative thoracic diagnoses with a special focus on radioprotection.
methodsA retrospective, single-centre study of 659 patients evaluated in the Emergency Department (ED) between January 2023 and November 2025. Data were extensively stratified by patient age, presenting symptoms, D-dimer thresholds, and radiological outcomes.
resultsThe global diagnostic yield was 20.9% (138/659). Advanced age correlated linearly with PE prevalence (25.2% in patients > 70 years) but inversely with D-dimer specificity, resulting in a 42% false-positive biomarker rate in the geriatric cohort. Dyspnea was the most common presenting symptom (62%) but demonstrated limited diagnostic specificity for PE. Crucially, in the 521 PE-negative scans, CTPA provided clinically relevant alternative diagnoses in 72.0% of cases (375/521), primarily infectious consolidations and heart failure.
conclusionWhile clinical triage remains within optimal international benchmarks, the standard diagnostic algorithm is heavily confounded by patient age and inflammatory "PE mimics." Integrating age-adjusted D-dimer thresholds and structured pre-test probability scoring is imperative to optimize resource allocation and mitigate unnecessary radiation exposure while preserving diagnostic safety (Righini in JAMA 311:1117-1124, 2014;Konstantinides in Eur Heart J 41:543-603, 2020;).
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