Featured Research

from universities, journals, and other organizations

CT angiography may be unnecessary in patients with suspected pulmonary embolism

Date:
June 15, 2010
Source:
Radiological Society of North America
Summary:
A new study suggests that computed tomography (CT) angiography might be unnecessary in many patients suspected of having pulmonary embolism (PE), based on the results of risk assessment analysis. PE risk assessment could help reduce radiation exposure and costs associated with CT angiography.

A new study suggests that computed tomography (CT) angiography might be unnecessary in many patients suspected of having pulmonary embolism (PE), based on the results of risk assessment analysis. PE risk assessment could help reduce radiation exposure and costs associated with CT angiography.

The results of the study appear in the online edition and August print issue of the journal Radiology.

"Our study suggests that the frequency of ordering CT angiograms can be markedly reduced with resultant cost-savings and decreased radiation exposure," said lead author Mark D. Mamlouk, M.D., radiology resident at the University of California, Irvine in Orange, Calif.

Pulmonary embolism occurs when a blood clot, usually from the leg, travels through the bloodstream and gets lodged in a pulmonary artery. The condition can be fatal, so prompt diagnosis is critical.

CT angiography's high sensitivity and specificity has made it the preferred modality for diagnosing PE. However, the increasing use of the examination has fueled concerns over procedure costs and radiation exposure to patients, along with risks associated with the use of contrast agents.

For the study, the researchers assessed the possibility of using risk factors associated with thromboembolism, or blood clot formation, to reduce the number of CT angiograms for PE. They reviewed the electronic medical records of 2,003 patients who underwent CT angiography for possible PE between July 2004 and February 2006. Among the risk factors assessed were age, history of immobilization and cancer. Other risk factors included excess estrogen state, a history of venous thromboembolism, gender and disorders that cause blood to clot more easily than normal.

Overall, CT angiograms were negative for PE in 1,806 of 2,003 patients, or 90.2 percent. Among the 197 patients with CT angiograms positive for PE, 192, or 97.5 percent, had one or more risk factors.

All of the risk factors except gender were determined to be statistically significant. Age of 65 years or older and immobilization were the most common risk factors in positive PE patients.

Of the 1,806 patients with CT angiograms negative for PE, 520 (28.8 percent) had no risk factors. Furthermore, excluding age and gender, 1,119 (62 percent) had no risk factors. Risk factor assessment had a sensitivity of 97.5 percent and a negative predictive value of 99 percent in all patients.

Without any thromboembolic risk factors, there was only a 0.95 percent chance of a CT angiogram positive for PE, according to Dr. Mamlouk.

"Thromboembolic risk factor assessment is an effective clinical method to determine when to perform CT angiography for PE," Dr. Mamlouk said. "Risk assessment can be performed when clinicians acquire their patients' history. It takes only a few minutes, and there's no cost."

Dr. Mamlouk and colleagues also concluded that the combination of no risk factors and a negative D-dimer, a blood test that helps in the diagnosis of blood clots, yielded an extraordinarily low risk for a positive CT angiogram for PE.


Story Source:

The above story is based on materials provided by Radiological Society of North America. Note: Materials may be edited for content and length.


Journal Reference:

  1. Mark D. Mamlouk, Eric Vansonnenberg, Rishi Gosalia, David Drachman, Daniel Gridley, Jesus G. Zamora, Giovanna Casola, Sanford Ornstein. Pulmonary Embolism at CT Angiography: Implications for Appropriateness, Cost, and Radiation Exposure in 2003 Patients. Radiology, 2010; 10091624 DOI: 10.1148/radiol.10091624

Cite This Page:

Radiological Society of North America. "CT angiography may be unnecessary in patients with suspected pulmonary embolism." ScienceDaily. ScienceDaily, 15 June 2010. <www.sciencedaily.com/releases/2010/06/100615093232.htm>.
Radiological Society of North America. (2010, June 15). CT angiography may be unnecessary in patients with suspected pulmonary embolism. ScienceDaily. Retrieved July 23, 2014 from www.sciencedaily.com/releases/2010/06/100615093232.htm
Radiological Society of North America. "CT angiography may be unnecessary in patients with suspected pulmonary embolism." ScienceDaily. www.sciencedaily.com/releases/2010/06/100615093232.htm (accessed July 23, 2014).

Share This




More Health & Medicine News

Wednesday, July 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins