Diagnosing Pulmonary Embolism: Accentuate the (True) Positive, Eliminate the (False) Negative

In a large randomized study, CTPA was as effective a diagnostic tool as V/Q scanning.

The diagnosis of pulmonary embolism (PE) can elude even experienced clinicians. Although ventilation-perfusion (V/Q) lung scanning has been the noninvasive imaging procedure of choice for several decades, computed tomography pulmonary angiography (CTPA) has recently replaced V/Q scanning in many institutions, because it produces a clear positive or negative result quickly. However, assessments of CTPA’s sensitivity have varied widely, and no direct comparison of V/Q scanning with CTPA has been performed. Now, researchers have reported results of a randomized, controlled, investigator-blinded study of CTPA versus V/Q scanning in patients with suspected PE based on a Wells clinical model score of ≥4.5 or a positive d-dimer assay. The main out…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)