Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism

Letters3 May 2005Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary EmbolismPieter W. Kamphuisen, MD and Giancarlo Agnelli, MDPieter W. Kamphuisen, MDFrom University of Perugia, I-06100 Perugia, Italy.Search for more papers by this author and Giancarlo Agnelli, MDFrom University of Perugia, I-06100 Perugia, Italy.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-9-200505030-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In many hospitals, CTPA is becoming the preferred diagnostic test for suspected acute PE. On the basis of their meta-analysis, Moores and colleagues (1) concluded that it appears to be safe to withhold anticoagulant therapy after negative CTPA results in patients with suspected PE. This may imply that CTPA could be used as the first and sole diagnostic test in these patients. We believe that this conclusion is premature for 2 reasons.First, in consecutive patients with suspected PE, the sensitivity of CTPA is only 70% and the negative likelihood ratio is 0.3 (2). This likelihood ratio ...References1. Moores LK, Jackson WL, Shorr AF, Jackson JL. Meta-analysis: outcomes in patients with suspected pulmonary embolism managed with computed tomographic pulmonary angiography. Ann Intern Med. 2004;141:866-74. [PMID: 15583229] LinkGoogle Scholar2. Perrier A, Howarth N, Didier D, Loubeyre P, Unger PF, de Moerloose P, et al. Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism. Ann Intern Med. 2001;135:88-97. [PMID: 11453707] LinkGoogle Scholar3. Goodman LR, Curtin JJ, Mewissen MW, Foley WD, Lipchik RJ, Crain MR, et al. Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. AJR Am J Roentgenol. 1995;164:1369-74. [PMID: 7754875] CrossrefMedlineGoogle Scholar4. Stein PD, Hull RD, Patel KC, Olson RE, Ghali WA, Brant R, et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med. 2004;140:589-602. [PMID: 15096330] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Perugia, I-06100 Perugia, Italy.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPerformance of Helical Computed Tomography in Unselected Outpatients with Suspected Pulmonary Embolism Arnaud Perrier , Nigel Howarth , Dominique Didier , Pierre Loubeyre , Pierre-François Unger , Philippe de Moerloose , Daniel Slosman , Alain Junod , and Henri Bounameaux d-Dimer for the Exclusion of Acute Venous Thrombosis and Pulmonary Embolism Paul D. Stein , Russell D. Hull , Kalpesh C. Patel , Ronald E. Olson , William A. Ghali , Rollin Brant , Rita K. Biel , Vinay Bharadia , and Neeraj K. Kalra Meta-Analysis: Outcomes in Patients with Suspected Pulmonary Embolism Managed with Computed Tomographic Pulmonary Angiography Lisa K. Moores , William L. Jackson Jr. , Andrew F. Shorr , and Jeffrey L. Jackson Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism Lisa K. Moores and William L. Jackson Jr Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism Shaun D. Frost Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism Philippe Girard Metrics Cited byOutcomes following a negative computed tomography pulmonary angiography according to pulmonary embolism prevalence: a meta‐analysis of the management outcome studiesUpdate in the diagnosis of deep-vein thrombosis and pulmonary embolism 3 May 2005Volume 142, Issue 9Page: 801-802KeywordsAngiographyAnticoagulant therapyComputed axial tomographyConflicts of interestLungsPatientsPulmonary embolismRadiation exposure ePublished: 3 May 2005 Issue Published: 3 May 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...