What is the recommended wording in a CT chest report when the study is negative for pulmonary embolism but clinical suspicion remains?

What is the recommended wording in a CT chest report when the study is negative for pulmonary embolism but clinical suspicion remains?

• A. No acute pulmonary embolism detected; note limitations (motion, subsegmental findings) and suggest clinical correlation or alternative imaging if warranted.
• B. There is no pulmonary embolism present; no further imaging is needed.
• C. Pulmonary embolism is excluded; there are no artifacts affecting interpretation.
• D. Indeterminate for pulmonary embolism due to artifacts; repeat CT is required.

Answer: (A)

When a CT chest study is negative for pulmonary embolism but clinical suspicion remains, the wording should convey the negative result while explicitly acknowledging possible limitations and guiding the next steps. The best phrasing states that no acute pulmonary embolism is detected, notes potential study limitations (such as motion or subsegmental findings that could affect interpretation), and recommends clinical correlation or consideration of alternative imaging if warranted. This approach communicates that the absence of a clear PE on this study does not definitively rule out disease and provides a rationale for further evaluation if the patient’s symptoms persist or worsen. Other phrasings are less appropriate because they overstate certainty (no further imaging needed or PE excluded with no artifacts) or label the study indeterminate due to artifacts. In real practice, it’s important to acknowledge limitations and keep a pathway open for additional assessment when clinical concern remains.

When a CT chest study is negative for pulmonary embolism but clinical suspicion remains, the wording should convey the negative result while explicitly acknowledging possible limitations and guiding the next steps. The best phrasing states that no acute pulmonary embolism is detected, notes potential study limitations (such as motion or subsegmental findings that could affect interpretation), and recommends clinical correlation or consideration of alternative imaging if warranted. This approach communicates that the absence of a clear PE on this study does not definitively rule out disease and provides a rationale for further evaluation if the patient’s symptoms persist or worsen.

Other phrasings are less appropriate because they overstate certainty (no further imaging needed or PE excluded with no artifacts) or label the study indeterminate due to artifacts. In real practice, it’s important to acknowledge limitations and keep a pathway open for additional assessment when clinical concern remains.