Authors
Kirthi Sathyakumar, Vijayan Purushothaman, Joses Dany James, Vignesh Kumar
Published in
Emergency radiology. Jun 25, 2026. Epub Jun 25, 2026.
Abstract
Computed tomography [CT] is the frontline imaging modality for the assessment of polytrauma patients because of its speed, diagnostic accuracy and influence on immediate management. Ever since whole-body CT [WB-CT or "pan-scan"] was adopted, there has been ongoing debate about patient selection, optimal protocols and acquisition strategies, radiation safety, and its integration into streamlined trauma workflows. Evidence suggests that WB-CT shortens time-to-diagnosis and improves injury detection compared with region-specific selective CT, although mortality benefits are variable across studies and the radiation dose remains marginally higher. Newer protocol variants, such as the split-bolus single-pass technique, dual-energy CT [DECT], dose-reduced and hybrid timing strategies, monophasic acquisition in select patients aim to optimize diagnostic accuracy while reducing dose and contrast. Structured reporting using trauma-specific templates improve completeness and diagnostic performance, particularly among less experienced radiologists. Emerging tools such as artificial intelligence [AI] triage/flagging systems, photon-counting and spectral CT, and automated structured reporting can potentially improve the trauma workflow efficiency. This article reviews current guidelines, compares WB-CT with selective CT, discusses existing WB-CT protocols, proposes a practical optimized WB-CT protocol termed - 'IMPACT Protocol [Integrated Multiphase Polytrauma Assessment CT]',and offers recommendations for structured reporting and future implementation.
PMID:
42348107
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.
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