Planning and performing CT-guided interventions for source control in septic patients: a survey by the European Society of Emergency Radiology

OBJECTIVES: To analyze emergency radiologists' perspectives on computed tomography (CT)-guided interventions for source control in patients with sepsis. MATERIALS AND METHODS: In 2023, members of the European Society of Emergency Radiology (ESER) were surveyed on the use of CT in the management of sepsis (n = 297). The questionnaire included demographic details, clinical experience, and questions on the timing and justification for CT. In a secondary analysis focused on CT-guided interventions, the obtained data were compared to results from a previous single-center survey among clinicians and general radiologists (n = 719). Responses were gathered anonymously, and data were analyzed using descriptive statistics and chi-square tests. RESULTS: The perspectives of 144 emergency radiologists were compared with those of 719 participants from various specialties. Most respondents, i.e., 85.3% (n = 58) of emergency radiologists, strongly agreed on the importance of CT for planning interventions in patients with sepsis. Preferences for the timing of CT-guided intervention leaned towards 1-6 h among emergency radiologists (66.7%, n = 36) and clinicians (64.1%, n = 211), while a majority of general radiologists accepted 6-12-h (58.3%, n = 14). Professional experience did not affect the agreement on the importance of CT among emergency radiologists (board-certified, 85.7% (n = 30) vs senior, 84.8% (n = 28)) or timing preferences (board-certified, 60.7% (n = 17) vs senior, 73.1% (n = 19)). CONCLUSION: The ESER survey confirmed the importance physicians attach to CT for planning interventions in patients with sepsis. While preferences for intervention timing varied slightly among specialties, there was a wide agreement on the importance of prompt CT-guided interventions within the first 12 h of focus detection. KEY POINTS: Question What is the expert assessment on the significance of CT imaging for procedure planning and on the ideal timing of CT-guided interventions in sepsis. Findings the surveyed experts value CT for planning interventions in patients with sepsis, and a prompt CT-guided intervention ideally within the 6 h of focus detection. Critical relevance statement specialized imaging techniques and minimally invasive treatments for source control become more widely used. The perspective of emergency radiologists compared to that of general radiologists and clinicians helps to weigh the role of CT-guided interventions in septic patients.