Summary – Rising Use of CT Pulmonary Angiography (CTPA)
Summary – Rising Use of CT Pulmonary Angiography (CTPA)
Source: ScienceDirect, May 12, 2025
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1. CTPA usage has increased by 49% over the past 7 years (2017–2023), especially in emergency departments.
2. Exams increased from 2,467 in 2017 to 3,684 in 2023.
3. The positivity rate remained stable at ~9.1%, suggesting overuse despite rising volume.
4. Reasons for preference include:
• High sensitivity and specificity
• Fast turnaround time
• Less invasive than catheter angiography
5. Concerns of overuse persist, especially for patients with low clinical suspicion of PE.
6. CTPA is often ordered to exclude multiple conditions such as PE, aortic dissection, or malignancy when symptoms overlap.
7. The COVID-19 pandemic drove higher usage, as patients with respiratory symptoms were screened for PE more often.
8. Patient and workflow patterns influenced results:
• Higher positivity in Black men and those with high BMI or cancer
• Lowest positivity in Asian patients
• Scans during overnight shifts were less likely to be positive
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Clarifying Question: Can CTPA also evaluate the coronary arteries?
Short Answer:
No — standard CTPA cannot reliably assess coronary arteries.
The two studies (CTPA and coronary CTA) have different contrast timing, ECG-gating, and technical requirements. If both coronary and pulmonary arteries need evaluation, a specialized “Triple Rule-Out CT” is required, which includes ECG gating and higher technical demands. This is not part of routine CTPA.
Full explanation available here
