{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T07:12:24Z","timestamp":1773558744699,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1123733 (fellowship for Claudia C. Dobler)"],"award-info":[{"award-number":["APP1123733 (fellowship for Claudia C. Dobler)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>(1) Background: Computed tomography pulmonary angiography (CTPA) is the standard imaging test for the evaluation of acute pulmonary embolism (PE), but it is associated with patients\u2019 exposure to radiation. Studies have suggested that radiation exposure can be reduced without compromising PE detection by limiting the scan range (the z-axis, going from up to down); (2) Methods: A literature search was conducted in MEDLINE and EMBASE on 17 July 2021. Studies were included if they enrolled patients who had undergone a CTPA and described the yield of PE diagnoses, number of missed filling defects and\/or other diagnoses using a reduced z-axis in comparison to a full-length scan. To assess risk of bias, we modified an existing risk of bias tools for observational studies, the Newcastle-Ottawa Scale. Results were synthesized in a narrative review. Primary outcomes were the number of missed PE diagnoses (based on at least one filling defect) and filling defects; the secondary outcome was the number of other missed findings; (3) Results: Eleven cohort studies and one case-control study were included reporting on a total of 3955 scans including 1025 scans with a diagnosis of PE. Six different reduced scan ranges were assessed; the most studied was from the top of the aortic arch to below the heart, in which no PEs were missed (seven studies). One sub-segmental PE was missed when the scan coverage was 10 cm starting from the bottom of the aortic arch and 14.7 cm starting from the top of the arch. Five studies that reported on other findings all found that other diagnoses were missed with a reduced z-axis. Most of the included studies had a high risk of bias; (4) Conclusions: CTPA scan coverage reduction from the top of aortic arch to below the heart reduced radiation exposure without affecting PE diagnoses, but studies were generally at high risk of bias.<\/jats:p>","DOI":"10.3390\/diagnostics11122179","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T01:49:58Z","timestamp":1638150598000},"page":"2179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Effect of Limiting the Scan Range of Computed Tomography Pulmonary Angiography (to Reduce Radiation Exposure) on the Detection of Pulmonary Embolism: A Systematic Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4310-0266","authenticated-orcid":false,"given":"Amayar","family":"Zaw","sequence":"first","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Liverpool Hospital, Sydney 2107, Australia"},{"name":"South Western Sydney Clinical School, University of New South Wales, Sydney 2107, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8940-3161","authenticated-orcid":false,"given":"Rebecca","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Liverpool Hospital, Sydney 2107, Australia"},{"name":"South Western Sydney Clinical School, University of New South Wales, Sydney 2107, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leon","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Radiology, Liverpool Hospital, Sydney 2107, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Kaplan","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School, University of New South Wales, Sydney 2107, Australia"},{"name":"Department of Radiology, Liverpool Hospital, Sydney 2107, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-0189","authenticated-orcid":false,"given":"Claudia C.","family":"Dobler","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Liverpool Hospital, Sydney 2107, Australia"},{"name":"South Western Sydney Clinical School, University of New South Wales, Sydney 2107, Australia"},{"name":"The George Institute for Global Health, Sydney 2042, Australia"},{"name":"Woolcock Institute of Medical Research, The University of Sydney, Sydney 2037, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1053\/j.tvir.2017.07.002","article-title":"Epidemiology, pathophysiology, stratification, and natural history of pulmonary embolism","volume":"20","author":"Giordano","year":"2017","journal-title":"Tech. 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