Does Your Patient Really Need Another Chest CT?

Computed tomography (CT) angiography of the chest is considered the definitive test for pulmonary embolism (PE) in the emergency department. Although CT angiography is readily available, it exposes patients to ionizing radiation and iodinated contrast dye (JW Emerg Med Aug 3 2007). In a prospective study of 675 ED patients who underwent chest CT angiography for the work-up of PE, researchers assessed rates of repeat chest CT angiography.

During 5 years of follow-up, 33% of patients underwent repeat chest CT angiography. Of the patients who underwent repeat testing, 22% were women younger than 40. Overall, 5.3% of index scans were positive for PE, compared with 3.4% of subsequent scans.