Frequency and Causes of False-Positive Ctpa Exams in Community Hospitals

Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography

“…In a 2011 study of 70 isolated subsegmental PEs by Pena et al [13], a reviewing thoracic radiologist reinterpreted 11% of these examinations as negative. In a separate abstract published by Miller et al [18], a single thoracic radiologist found a false-positive or probable false-positive rate of 11% at all pulmonary artery levels in 508 cases. Compared with these previous studies, the current study is larger and uses a panel of three subspecialty chest radiologists as a more robust surro- …”

“…In our study, the most common cause identified for the misdiagnosis of PE was motion artifact due to breathing, which accounted for 42.2% of cases. Breathing artifact has previously been shown to be the most common mimic of PE [18] as well as the most common cause of equivocal pulmonary CTA findings in up to 74% of cases [9]. Breathing artifact can most easily be identified on a lung window by the presence of the seagull artifact, the stair-step artifact, and rapid changes in position of vessels on contiguous image slices [10] (Fig.…”

“…Although pulmonary CTA examinations are frequently interpreted by general radiologists in most centers, limited data exist on the interobserver agreement between general and subspecialist chest radiologists. A small number of studies [13,18] have directly compared pulmonary CTA interpretation by general radiologists with that of a single subspecialist chest radiologist. There is very limited analysis of these discrepant cases in terms of PE location within the pulmonary arterial system and potential causes of misdiagnosis.…”

The High Risk of Contrast‐induced Nephropathy in Patients with Suspected Pulmonary Embolism Despite Three Different Prophylaxis: A Randomized Controlled Trial

“…This rate is much higher than that in other recent studies. 24,25 This may be attributed to our patient group being at greater risk of PE compared to the general population receiving contrast-enhanced CTPA since our patients were selected from among subjects with at least one risk factor for CIN. At the same time, current knowledge shows that PEs diagnosed by contrast enhanced CTPA are frequently overdiagnosed.…”