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RadiologyDiagnostic
Pulmonary Embolism Imaging Protocol Selection
Pulmonary Embolism Imaging Protocol Selection: Suspected Pulmonary Embolism → Calculate Pretest Probability → D-dimer Result → PE Excluded.
Pathway Overview
8 steps
Algorithm Steps
8 total
01Start 02Action Calculate Pretest Probability
Wells Score or YEARS criteria
03Decision D-dimer Result
- Negative
- Positive
- High pretest - skip
04End PE Excluded
Negative D-dimer + low pretest
05Decision CTPA Contraindications?
- None
- Renal/contrast
- Pregnancy
06End CTPA
First-line for most patients
07End V/Q Scan
Preferred for pregnancy, renal failure
08Action LE Doppler First
If positive, can treat without CTPA
Guideline Source
ACR Appropriateness Criteria: Suspected Pulmonary Embolism
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- CTPA sensitivity lower for subsegmental PE
- V/Q often nondiagnostic with underlying lung disease
- Clinical judgment required for borderline cases
Applicable Regions
USAUUKEU
EU: ESC guidelines; emphasis on YEARS algorithm
US: CTPA standard first-line; PIOPED for V/Q
Version 1Next review: 2028-01-01
Next steps
Finish the workflow by opening the most relevant calculator, then convert the session into a live account when you are ready.
Related Resources
Frequently Asked Questions
What is the Pulmonary Embolism Imaging Protocol Selection?
The Pulmonary Embolism Imaging Protocol Selection is a diagnostic clinical algorithm for Radiology. It provides a structured decision tree to guide clinical decision-making, based on ACR Appropriateness Criteria: Suspected Pulmonary Embolism.
What guideline is the Pulmonary Embolism Imaging Protocol Selection based on?
This algorithm is based on ACR Appropriateness Criteria: Suspected Pulmonary Embolism (DOI: 10.1016/j.jacr.2021.04.013).
What are the limitations of the Pulmonary Embolism Imaging Protocol Selection?
Known limitations include: CTPA sensitivity lower for subsegmental PE; V/Q often nondiagnostic with underlying lung disease; Clinical judgment required for borderline cases. Individual patient factors may require deviation from these recommendations.
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