Optimal Approach to Performing and Reporting Computed Tomography Angiography for Suspected Acute Pulmonary Embolism: A Clinical Consensus Statement of the ESC Working Group on Pulmonary Circulation & Right Ventricular Function, the Fleischner Society, the Association for Acute Cardiovascular Care (ACVC) and the European Association of Cardiovascular Imaging (EACVI) of the ESC, Endorsed by European Respiratory Society (ERS), Asian Society of Thoracic Radiology (ASTR), European Society of Thoracic Imaging (ESTI), and Society of Thoracic Radiology (STR)
Radiology, vol. 315, pp. e243833
Abstract
CT angiography (CTA) is the modality used most frequently for diagnosing acute pulmonary embolism (PE). Given the vast amount of information that can be extracted from CTA, the CTA report should be written in a way that conveys all relevant findings using standardized nomenclature and definitions. Broad consensus on a core set of CTA findings that are relevant for all PE patients is not currently available. This clinical consensus statement written by the European Society of Cardiology (ESC) Working Group on Pulmonary Circulation & Right Ventricular Function, the Fleischner Society, and the Association for Acute Cardiovascular Care and the European Association of Cardiovascular Imaging of the ESC provides a current update of CTA techniques, a definition of often-used nomenclature and recommendations on the proposed content of CTA reports along with a detailed image atlas with instructions on how to assess all relevant CTA findings and a lay language guidance on the meaning of these findings. Ultimately, upon implementation, this document is expected to standardize CTA radiology reports with respect to diagnostic and prognostic CT imaging findings to guide and harmonize management decisions, ultimately improving outcomes of care for PE patients. This article has been co-published with permission in the European Heart Journal – Cardiovascular Imaging and Radiology. All rights reserved. © The European Society of Cardiology and the Fleischner Society 2025. The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article. Supplemental material is available for this article. Keywords: Pulmonary embolism • Computed tomography • Reference standards • Outcome • Prognosis • Diagnosis
Authors 18
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Johannes Gutenberg University Mainz · Leiden University Medical Center · University Medical Center of the Johannes Gutenberg University Mainz
Affiliation as printed
Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
Department of Medicine—Thrombosis and Hemostasis, Leiden University Medical Center, LUMC Room C-7-68, Albinusdreef 2, 2300RC Leiden, the Netherlands
Department of Medicine—Thrombosis and Hemostasis, Leiden University Medical Center, LUMC Room C-7-68, Albinusdreef 2, 2300RC Leiden, the Netherlands
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Johannes Gutenberg University Mainz · University Medical Center of the Johannes Gutenberg University Mainz · University Hospital Zurich
Affiliation as printed
Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
Department of Angiology, University Hospital Zurich, Zurich, Switzerland
Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
Department of Angiology, University Hospital Zurich, Zurich, Switzerland
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Inserm · Mines Saint-Étienne · Centre Hospitalier Universitaire de Saint-Étienne · SAnté INgenierie BIOlogie Saint-Etienne · Université Jean Monnet
Affiliation as printed
Département of Médecine Vasculaire et Thérapeutique, CHU Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, CIC 1408, Université Jean Monnet Saint-Étienne, SaintÉtienne 42055, France
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Washington University in St. Louis
Affiliation as printed
Department of Radiology, Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA
Department of Radiology, Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA
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University of Ottawa · Ottawa Hospital Research Institute
Affiliation as printed
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Affiliation as printed
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
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Inserm · Université Paris-Saclay · Assistance Publique – Hôpitaux de Paris · Bicêtre Hospital
Affiliation as printed
Université Paris-Saclay, Faculté de Médecine, Inserm UMR_S 999, Service de Pneumologie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
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Johannes Gutenberg University Mainz · University Medical Center of the Johannes Gutenberg University Mainz
Affiliation as printed
Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Affiliation as printed
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Center for Cardiovascular Medicine, Währinger Gürtel 18-20, Vienna 1090, Austria
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Affiliation as printed
Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Japan
Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Japan
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Royal Brompton Hospital · Imperial College London
Affiliation as printed
Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, UK
Royal Brompton Hospital, National Heart & Lung Institute, Imperial College London, London, UK
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Radboud University Nijmegen · Radboud University Medical Center
Affiliation as printed
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
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Affiliation as printed
Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
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Affiliation as printed
Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
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University of California San Diego
Affiliation as printed
Department of Surgery, University of California, San Diego, La Jolla, CA, USA
Department of Surgery, University of California, San Diego, La Jolla, CA, USA
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Radboud University Nijmegen · Radboud University Medical Center
Affiliation as printed
Radboud University Medical Center, Nijmegen (Netherlands)-IMALLIANCE Hauts-de-France, Valenciennes, France
Radboud University Medical Center, Nijmegen (Netherlands)-IMALLIANCE Hauts-de-France, Valenciennes, France
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