Acute pulmonary embolism: Assessment of helical CT for diagnosis

Elizabeth A. Drucker, S. Mitchell Rivitz, Jo Anne O. Shepard, Phillip M. Boiselle, Beatrice Trotman-Dickenson, Timothy J. Welch, Timothy Maus, Stephen W. Miller, John A. Kaufman, Arthur C. Waltman, Theresa C. McLoud, Christos A. Athanasoulis

Research output: Contribution to journalArticle

211 Citations (Scopus)

Abstract

PURPOSE: To determine the sensitivity and specificity of helical computed tomography (CT) for the diagnosis of acute pulmonary embolism. MATERIALS AND METHODS: This prospective study included 47 patients who underwent pulmonary arteriography for evaluation for possible acute pulmonary embolism. Tailored helical CT and pulmonary arteriography were performed within 24 hours of each other. Each CT scan was interpreted by two chest radiologists, blinded to arteriographic results, at two institutions. CT scan interpretations were compared with findings on bilateral selective pulmonary arteriograms interpreted by two vascular radiologists at one institution. RESULTS: Fifteen (32%) of 47 patients had angiographically proved pulmonary embolism. For the readers at the first institution, helical CT had 60% sensitivity, 81% specificity, 60% positive predictive value, 81% negative predictive value, and 75% overall accuracy. For the readers at the second institution, helical CT had 53% sensitivity, 97% specificity, 89% positive predictive value, 82% negative predictive value, and 83% accuracy. CONCLUSION: Detection of pulmonary embolism with helical CT may be less accurate than previously reported. Given its high specificity but relatively low sensitivity, helical CT may not have the ideal attributes of a first- line imaging study for the diagnosis of pulmonary embolism.

Original languageEnglish (US)
Pages (from-to)235-241
Number of pages7
JournalRadiology
Volume209
Issue number1
DOIs
StatePublished - Jan 1 1998

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Spiral Computed Tomography
Pulmonary Embolism
Sensitivity and Specificity
Lung
Angiography
Tomography
Blood Vessels
Thorax
Prospective Studies

Keywords

  • Computed tomography (CT), comparative studies
  • Embolism, pulmonary
  • Pulmonary angiography
  • Pulmonary arteries, CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Drucker, E. A., Rivitz, S. M., Shepard, J. A. O., Boiselle, P. M., Trotman-Dickenson, B., Welch, T. J., ... Athanasoulis, C. A. (1998). Acute pulmonary embolism: Assessment of helical CT for diagnosis. Radiology, 209(1), 235-241. https://doi.org/10.1148/radiology.209.1.9769837

Acute pulmonary embolism : Assessment of helical CT for diagnosis. / Drucker, Elizabeth A.; Rivitz, S. Mitchell; Shepard, Jo Anne O.; Boiselle, Phillip M.; Trotman-Dickenson, Beatrice; Welch, Timothy J.; Maus, Timothy; Miller, Stephen W.; Kaufman, John A.; Waltman, Arthur C.; McLoud, Theresa C.; Athanasoulis, Christos A.

In: Radiology, Vol. 209, No. 1, 01.01.1998, p. 235-241.

Research output: Contribution to journalArticle

Drucker, EA, Rivitz, SM, Shepard, JAO, Boiselle, PM, Trotman-Dickenson, B, Welch, TJ, Maus, T, Miller, SW, Kaufman, JA, Waltman, AC, McLoud, TC & Athanasoulis, CA 1998, 'Acute pulmonary embolism: Assessment of helical CT for diagnosis', Radiology, vol. 209, no. 1, pp. 235-241. https://doi.org/10.1148/radiology.209.1.9769837
Drucker EA, Rivitz SM, Shepard JAO, Boiselle PM, Trotman-Dickenson B, Welch TJ et al. Acute pulmonary embolism: Assessment of helical CT for diagnosis. Radiology. 1998 Jan 1;209(1):235-241. https://doi.org/10.1148/radiology.209.1.9769837
Drucker, Elizabeth A. ; Rivitz, S. Mitchell ; Shepard, Jo Anne O. ; Boiselle, Phillip M. ; Trotman-Dickenson, Beatrice ; Welch, Timothy J. ; Maus, Timothy ; Miller, Stephen W. ; Kaufman, John A. ; Waltman, Arthur C. ; McLoud, Theresa C. ; Athanasoulis, Christos A. / Acute pulmonary embolism : Assessment of helical CT for diagnosis. In: Radiology. 1998 ; Vol. 209, No. 1. pp. 235-241.
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abstract = "PURPOSE: To determine the sensitivity and specificity of helical computed tomography (CT) for the diagnosis of acute pulmonary embolism. MATERIALS AND METHODS: This prospective study included 47 patients who underwent pulmonary arteriography for evaluation for possible acute pulmonary embolism. Tailored helical CT and pulmonary arteriography were performed within 24 hours of each other. Each CT scan was interpreted by two chest radiologists, blinded to arteriographic results, at two institutions. CT scan interpretations were compared with findings on bilateral selective pulmonary arteriograms interpreted by two vascular radiologists at one institution. RESULTS: Fifteen (32{\%}) of 47 patients had angiographically proved pulmonary embolism. For the readers at the first institution, helical CT had 60{\%} sensitivity, 81{\%} specificity, 60{\%} positive predictive value, 81{\%} negative predictive value, and 75{\%} overall accuracy. For the readers at the second institution, helical CT had 53{\%} sensitivity, 97{\%} specificity, 89{\%} positive predictive value, 82{\%} negative predictive value, and 83{\%} accuracy. CONCLUSION: Detection of pulmonary embolism with helical CT may be less accurate than previously reported. Given its high specificity but relatively low sensitivity, helical CT may not have the ideal attributes of a first- line imaging study for the diagnosis of pulmonary embolism.",
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AB - PURPOSE: To determine the sensitivity and specificity of helical computed tomography (CT) for the diagnosis of acute pulmonary embolism. MATERIALS AND METHODS: This prospective study included 47 patients who underwent pulmonary arteriography for evaluation for possible acute pulmonary embolism. Tailored helical CT and pulmonary arteriography were performed within 24 hours of each other. Each CT scan was interpreted by two chest radiologists, blinded to arteriographic results, at two institutions. CT scan interpretations were compared with findings on bilateral selective pulmonary arteriograms interpreted by two vascular radiologists at one institution. RESULTS: Fifteen (32%) of 47 patients had angiographically proved pulmonary embolism. For the readers at the first institution, helical CT had 60% sensitivity, 81% specificity, 60% positive predictive value, 81% negative predictive value, and 75% overall accuracy. For the readers at the second institution, helical CT had 53% sensitivity, 97% specificity, 89% positive predictive value, 82% negative predictive value, and 83% accuracy. CONCLUSION: Detection of pulmonary embolism with helical CT may be less accurate than previously reported. Given its high specificity but relatively low sensitivity, helical CT may not have the ideal attributes of a first- line imaging study for the diagnosis of pulmonary embolism.

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