Pulmonary embolism diagnosis and mortality with pulmonary CT angiography versus ventilation-perfusion scintigraphy: Evidence of overdiagnosis with CT?

American Journal of Roentgenology

Volumn 198, Issue 6, 2012, Pages 1340-1345

  Sheh, Steven H ^a,b   Bellin, Eran ^a   Freeman, Katherine D ^a,c   Haramati, Linda B ^a  

^a ALBERT EINSTEIN COLLEGE OF MEDICINE   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c Extrapolate LLC   (United States)

Author keywords

Mortality; Pulmonary CT angiography; Pulmonary embolism; Ventilation perfusion scintigraphy

Indexed keywords

ADULT; ARTICLE; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; CONTROLLED STUDY; DIAGNOSTIC IMAGING; DISEASE SEVERITY; FEMALE; HUMAN; INTERMETHOD COMPARISON; LUNG EMBOLISM; LUNG SCINTISCANNING; MAJOR CLINICAL STUDY; MALE; MORTALITY; PATIENT IDENTIFICATION; PRIORITY JOURNAL; RETROSPECTIVE STUDY; VENTILATION PERFUSION SCINTIGRAPHY;

ANGIOGRAPHY; COMORBIDITY; FEMALE; HUMANS; INCIDENCE; LOGISTIC MODELS; MALE; MIDDLE AGED; PERFUSION IMAGING; POISSON DISTRIBUTION; PULMONARY EMBOLISM; RETROSPECTIVE STUDIES; TOMOGRAPHY, X-RAY COMPUTED;

EID: 84861642446     PISSN: 0361803X     EISSN: 15463141     Source Type: Journal    
DOI: 10.2214/AJR.11.6426     Document Type: Article

References (38)

1. Anderson FA Jr, Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester DVT study. Arch Intern Med 1991; 151:933-938
2. Stein PD, Kayali F, Olson RE. Trends in the use of diagnostic imaging in patients hospitalized with acute pulmonary embolism. Am J Cardiol 2004; 93:1316-1317 (Pubitemid 38595696)
3. Schoepf UJ, Holzknecht N, Helmberger TK, et al. Subsegmental pulmonary emboli: improved detection with thin-collimation multi-detector row spiral CT. Radiology 2002; 222:483-490 (Pubitemid 34106123)
4. Patel S, Kazerooni EA, Cascade PN. Pulmonary embolism: optimization of small pulmonary artery visualization at multi-detector row CT. Radiology 2003; 227:455-460 (Pubitemid 36514762)
5. Anderson DR, Kahn SR, Rodger MA, et al. Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial. JAMA 2007; 298:2743-2753 (Pubitemid 350294297)
6. Stein PD, Fowler SE, Goodman LR, et al.; PIOPED II Investigators. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006; 354:2317-2327 (Pubitemid 43801277)
7. Perrier A, Bounameaux H. Accuracy or outcome in suspected pulmonary embolism. N Engl J Med 2006; 354:2383-2384
8. Glassroth J. Imaging of pulmonary embolism too much of a good thing? JAMA 2007; 298:2788-2789 (Pubitemid 350294303)
9. Mettler FA Jr, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology 2008; 248:254-263
10. Burge AJ, Freeman KD, Klapper PJ, Haramati LB. Increased diagnosis of pulmonary embolism without a corresponding decline in mortality during the CT era. Clin Radiol 2008; 63:381-386
11. Wiener RS, Schwartz LM, Woloshin S. Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. Arch Intern Med 2011; 171:831-837
12. Cushman M, Tsai AW, White RH, et al. Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. Am J Med 2004; 117:19-25 (Pubitemid 38801482)
13. Nijkeuter M, Söhne M, Tick LW, et al Christopher Study Investigators. The natural course of hemodynamically stable pulmonary embolism: clinical outcome and risk factors in a large prospective cohort study. Chest 2007; 131:517-523 (Pubitemid 46280414)
14. Carson JL, Kelley MA, Duff A, et al. The clinical course of pulmonary embolism. N Engl J Med 1992; 326:1240-1245
15. Stein EG, Haramati LB, Chamarthy M, Sprayregen S, Davitt MM, Freeman LM. Success of a safe and simple algorithm to reduce use of CT pulmonary angiography in the emergency department. AJR 2010; 194:392-397
16. D'Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 1998; 17:2265-2281
17. Goodman LR. Small pulmonary emboli: what do we know? Radiology 2005; 234:654-658 (Pubitemid 40250805)
18. Eyer BA, Goodman LR, Washington L. Clinicians'response to radiologists' reports of isolated subsegmental pulmonary embolism or inconclusive interpretation of pulmonary embolism using MDCT. AJR 2005; 184:623-628 (Pubitemid 46657275)
19. Mayo JR, Remy-Jardin M, Müller NL, et al. Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology 1997; 205:447-452 (Pubitemid 27467324)
20. Carrier M, Righini M, Wells PS, et al. Subsegmental pulmonary embolism diagnosed by computed tomography: incidence and clinical implications - a systematic review and meta-analysis of the management outcome. J Thromb Haemost 2010; 8:1716-1722
21. Park B, Messina L, Dargon P, Huang W, Ciocca R, Anderson FA. Recent trends in clinical outcomes and resource utilization for pulmonary embolism in the United States: findings from the nationwide inpatient sample. Chest 2009; 136:983-990
22. Horlander KT, Mannino DM, Leeper KV. Pulmonary embolism mortality in the United States, 1979-1998: an analysis using multiple-cause mortality data. Arch Intern Med 2003; 163:1711-1717 (Pubitemid 36898960)
23. Lilienfeld DE, Chan E, Ehland J, Godbold JH, Landrigan PJ, Marsh G. Mortality from pulmonary embolism in the United States: 1962 to 1984. Chest 1990; 98:1067-1072 (Pubitemid 20381262)
24. Lilienfeld DE, Godbold JH, Burke GL, Sprafka JM, Pham DL, Baxter J. Hospitalization and case fatality for pulmonary embolism in the twin cities: 1979-1984. Am Heart J 1990; 120:392-395 (Pubitemid 20229829)
25. Stein PD, Kayali F, Olson RE. Estimated case fatality rate of pulmonary embolism, 1979 to 1998. Am J Cardiol 2004; 93:1197-1199 (Pubitemid 38521063)
26. [No authors listed]. Low-molecular-weight heparin in the treatment of patients with venous thromboembolism. The Columbus Investigators. N Engl J Med 1997; 337:657-662
27. Prologo JD, Gilkeson RC, Diaz M, Asaad J. CT pulmonary angiography: a comparative analysis of the utilization patterns in emergency department and hospitalized patients between 1998 and 2003. AJR 2004; 183:1093-1096 (Pubitemid 44185104)
28. Hull RD, Raskob GE, Brant RF, et al. Low-molecular-weight heparin vs heparin in the treatment of patients with pulmonary embolism. American-Canadian Thrombosis Study Group. Arch Intern Med 2000; 160:229-236 (Pubitemid 30054343)
29. Quinlan DJ, McQuillan A, Eikelboom JW. Low-molecular-weight heparin compared with intravenous unfractionated heparin for treatment of pulmonary embolism: a meta- analysis of randomized, controlled trials. Ann Intern Med 2004; 140:175-183
30. Engelke C, Rummeny EJ, Marten K. Pulmonary embolism at multi-detector row CT of chest: one year survival of treated and untreated patients. Radiology 2006; 239:563-575
31. Suh JM, Cronan JJ, Healey TT. Dots are not clots: the over-diagnosis and over-treatment of pulmonary embolism. Emerg Radiol 2010; 17:347-352
32. Warren R, Eleti A. Overdiagnosis and overtreatment of breast cancer: is overdiagnosis an issue for radiologists? Breast Cancer Res 2006; 8:205
33. Yankelevitz DF. Quantifying "overdiagnosis" in lung cancer screening. (comment) Radiology 2008; 246:332-333; author reply 332-333
34. Donato AA, Khoche S, Santora J, et al. Clinical outcomes in patients with isolated subsegmental pulmonary emboli diagnosed by multidetector CT pulmonary angiography. Thromb Res 2010; 126:e266-e270
35. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism: a controlled trial. Lancet 1960; 1:1309-1312
36. Haspel J, Bauer K, Goehler A, et al. Long-term anticoagulant therapy for idiopathic pulmonary embolism in the elderly: a decision analysis. Chest 2009; 135:1243-1251
37. Stein EG, Haramati LB, Bellin E, et al. Radiation exposure from medical imaging in patients with chronic and recurrent conditions. J Am Coll Radiol 2010; 7:351-359
38. Kline JA, Courtney DM, Beam DM, King MC, Steuerwald M. Incidence and predictors of repeated computed tomographic pulmonary angiography in emergency department patients. Ann Emerg Med 2009; 54:41-48