Contrast-enhanced CT in sepsis: insights from a European Emergency Radiology survey

OBJECTIVES: To gain insight into emergency radiologists' views on the role of contrast-enhanced CT (CECT) in sepsis management. MATERIALS AND METHODS: This analysis of a survey distributed in 2023 to members of the European Society of Emergency Radiology (ESER) (n = 297) gathered perspectives on the role of CECT in patients with sepsis. The previously validated questionnaire used for this survey encompassed demographic information, clinical experience, and inquiries regarding the timing and rationale for CT. Results were compared with data from a prior single-center survey among clinicians and general radiologists. Responses were collected anonymously and analyzed using descriptive statistics and chi-square tests. As not all items were mandatory, item-specific response numbers may vary and are reported accordingly throughout the manuscript. RESULTS: A total of 144 emergency radiologists participated, with most of them endorsing a 1-6-h timeframe for CECT after the diagnosis of sepsis (45.8%; n = 27/59). However, a notable proportion accepted longer intervals > 12 h (35.6%; n = 21/59). Emergency radiologists particularly opted for repeat imaging in patients with sepsis and clinical deterioration (35.3%; 24/68), whereas clinicians tended to be more hesitant (2.9%; n = 10/341). CONCLUSION: The results of this survey indicate strong agreement among emergency radiologists on the relevance of prompt CECT for the timely diagnostic management of patients with sepsis. Several aspects related to timing and indication show significant interdisciplinary differences, requiring further study. KEY POINTS: Question While contrast-enhanced CT can aid in detecting the infectious focus, this study explores emergency radiologists' perspectives on its role in sepsis management. Findings Radiologists and clinicians from different subspecialties agree on the importance of promptly performed (≥ 1-6 h) CECT in sepsis management and the contraindications of contrast application. Clinical relevance This survey shows that radiologists and clinicians largely agree on the importance of CECT in sepsis management.