Can multislice CT alone rule out reliably pulmonary embolism? A prospective study

Guilabert, J. Pamies; Manzur, Dolores Nauffal; Tarrasa, Maria J. Torres; Llorens, Maximiliano Lloret; Braun, Petra; Arques, Maria P. Bello

doi:10.1016/j.ejrad.2006.11.032

Cited by 16 publications

(8 citation statements)

References 37 publications

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“…The references for the included studies are as follows: CTPA, [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] D-dimer, 30,31,36,[38][39][40] age-adjusted D-dimer, 40 proximal compression ultrasound, 39,67-72 VQ. 28,30,34,68,71,[73][74][75][76][77][78][79][80] Low PTP/prevalence (£5%) Question: In a patient population with a low clinical probability of PE, what is the optimal diagnostic strategy to evaluate for suspected first episode PE?…”

Section: Summary Of Evidencementioning

confidence: 99%

American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism

et al. 2018

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Background: Modern diagnostic strategies for venous thromboembolism (VTE) incorporate pretest probability (PTP; prevalence) assessment. The ability of diagnostic tests to correctly identify or exclude VTE is influenced by VTE prevalence and test accuracy characteristics. Objective: These evidence-based guidelines are intended to support patients, clinicians, and health care professionals in VTE diagnosis. Diagnostic strategies were evaluated for pulmonary embolism (PE), deep vein thrombosis (DVT) of the lower and upper extremity, and recurrent VTE. Methods: The American Society of Hematology (ASH) formed a multidisciplinary panel including patient representatives. The McMaster University GRADE Centre completed systematic reviews up to 1 October 2017. The panel prioritized questions and outcomes and used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess evidence and make recommendations. Test accuracy estimates and VTE population prevalence were used to model expected outcomes in diagnostic pathways. Where modeling was not feasible, management and accuracy studies were used to formulate recommendations. Results: Ten recommendations are presented, by PTP for patients with suspected PE and lower extremity DVT, and for recurrent VTE and upper extremity DVT. Conclusions: For patients at low (unlikely) VTE risk, using D-dimer as the initial test reduces the need for diagnostic imaging. For patients at high (likely) VTE risk, imaging is warranted. For PE diagnosis, ventilation-perfusion scanning and computed tomography pulmonary angiography are the most validated tests, whereas lower or upper extremity DVT diagnosis uses ultrasonography. Research is needed on new diagnostic modalities and to validate clinical decision rules for patients with suspected recurrent VTE.

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Section: Summary Of Evidencementioning

confidence: 99%

American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism

et al. 2018

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“…Diagnosis of VTE in cancer patients differs from the diagnostic rules accepted for remaining patients with VTE [71][72][73][74][75]. In the majority of cancer patients D-dimer levels could be increased without simultaneous VTE.…”

Section: Diagnosismentioning

confidence: 99%

“…Diagnosis of PE in cancer patients is based on angio-CT of pulmonary arteries, or less frequently on ventilation-perfusion scintigraphy [73].…”

Section: Diagnosismentioning

confidence: 99%

Guidelines for the prevention and treatment of venous thromboembolism in non-surgically treated cancer patients

Wojtukiewicz

Sierko

Tomkowski³

et al. 2016

Nowotwory. Journal of Oncology

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“…In PIOPED II, fourdetector row CTPA had a sensitivity of 83% and specificity of 96% compared with a composite reference standard [37]. The positive predictive values for four-detector row CTPA range from 92 to 96%, and the negative predictive values range from 94 to 100% [37,40]. The positive predictive values for four-detector row CTPA range from 92 to 96%, and the negative predictive values range from 94 to 100% [37,40].…”

Section: Ct Pulmonary Angiographymentioning

confidence: 99%

Imaging in thromboembolic disease

Kelly¹

2011

Imaging in Medicine

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Can multislice CT alone rule out reliably pulmonary embolism? A prospective study

Cited by 16 publications

References 37 publications

American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism

American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism

Guidelines for the prevention and treatment of venous thromboembolism in non-surgically treated cancer patients

Imaging in thromboembolic disease

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