Clinical Radiology
Volume 63, Issue 4 , Pages 381-386 , April 2008

Increased diagnosis of pulmonary embolism without a corresponding decline in mortality during the CT era

  • A.J. Burge

      Affiliations

    • Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
    • ,
  • K.D. Freeman

      Affiliations

    • Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
    • ,
  • P.J. Klapper

      Affiliations

    • Department of Internal Medicine, Division of Pulmonary Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
    • ,
  • L.B. Haramati

      Affiliations

    • Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
    • Corresponding Author InformationGuarantor and correspondent: L.B. Haramati, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210th Street, Bronx, New York 10467, USA. Tel.: +1 718 920 7458; fax: +1 718 798 7983.

Received 16 July 2007 ,Revised 14 October 2007 ,Accepted 17 October 2007.

References 

  1. Horlander KT, Mannino DM, Leeper KV. Pulmonary embolism mortality in the United States, 1979–1988. Arch Intern Med. 2003;163:1711–1717
  2. Thompson BT, Hales CA. Clinical manifestations of and diagnostic strategies for acute pulmonary embolism. In:  Rose BD editors. UpToDate. Waltham, MA: UpToDate; 2005;[accessed 12.04.06]
  3. Macdonald SLS, Mayo JR. Computed tomography of acute pulmonary embolism. Semin Ultrasound CT MR. 2003;24:217–231
  4. Fulkerson WJ, Coleman RE, Ravin CE, et al. Diagnosis of pulmonary embolism. Arch Intern Med. 1986;146:961–967
  5. The PIOPED Investigators . Value of the ventilation/perfusion scan in acute pulmonary embolism. JAMA. 1990;263:2753–2759
  6. Stein PD, Hull RD, Saltzman HA, et al. Strategy for diagnosis of patients with suspected acute pulmonary embolism. Chest. 1993;103:1553–1559
  7. Sinner WN. Computed tomographic patterns of pulmonary thromboembolism and infarction. J Comput Assist Tomogr. 1978;2:395–399
  8. Ghaye B, Remy J, Remy-Jardin M. Non-traumatic thoracic emergencies: CT diagnosis of acute pulmonary embolism: the first 10 years. Eur Radiol. 2002;12:1886–1905
  9. Remy-Jardin M, Remy J, Wattinne L, et al. Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single breath hold technique—comparison with pulmonary angiography. Radiology. 1992;185:381–387
  10. Goodman LR, Curtin JJ, Mewissen MW, et al. Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. AJR Am J Roentgenol. 1995;164:1369–1374
  11. Rathbun SW, Raskob GE, Whitsett TL. Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: a systematic review. Ann Intern Med. 2000;132:227–232
  12. Eng J, Krishnan JA, Segal JB, et al. Accuracy of CT in the diagnosis of pulmonary embolism: a systematic literature review. AJR Am J Roentgenol. 2004;183:1819–1827
  13. Goldhaber SZ. Multislice computed tomography for pulmonary embolism—a technological marvel. N Engl J Med. 2005;352:1812–1814
  14. Quiroz R, Kucher N, Kipfmueller F, et al. Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review. JAMA. 2005;293:2012–2017
  15. Perrier AP, Roy PM, Sanchez O, et al. Multidetector row computed tomography in suspected pulmonary embolism. N Engl J Med. 2005;352:1760–1768
  16. Stein PD, Kayalli F, Olson RE. Trends in the use of diagnostic imaging in patients hospitalized with acute pulmonary embolism. Am J Cardiol. 2004;93:1316–1317
  17. 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
  18. Valentine KA, Hull RD. Treatment of acute pulmonary embolism. In:  Rose BD editors. UpToDate. Waltham, MA: UpToDate; 2005;[accessed 12.04.06]
  19. Wheeler AP, Jaquiss RD, Newman JH. Physician practices in the treatment of pulmonary embolism and deep venous thrombosis. Arch Intern Med. 1988;148:1321–1325
  20. Hull RD, Raskob GE, Brant RF, et al. The importance of initial heparin treatment on long-term clinical outcomes of antithrombotic therapy. the emerging theme of delayed recurrence. Arch Intern Med. 1997;157:2317–2321
  21. Simonneau G, Sors H, Charbonnier B, et al. A comparison of low molecular weight heparin with unfractionated heparin for acute pulmonary embolism. N Engl J Med. 1997;337:663–669
  22. The Columbus Investigators . Low molecular weight heparin in the treatment of patients with venous thromboembolism. N Engl J Med. 1997;337:657–662
  23. Quinlan DJ, Mc Quillan 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
  24. Wan S, Quinlan DJ, Agnilli G, et al. Thrombolysis compared with heparin for the initial treatment of pulmonary embolism: a meta-analysis of the randomized controlled trials. Circulation. 2004;110:744–749
  25. Kucher N, Rossi E, De Rosa M, et al. Massive pulmonary embolism. Circulation. 2006;113:577–582
  26. www.nyhealthgov/statistics.sparcs[accessed 2007]
  27. Prologo JD, Gilkeson RC, Diaz M, et al. CT pulmonary angiography: a comparative analysis of the utilization patterns in emergency department and hospitalized patients between 1998 and 2003. AJR Am J Roentgenol. 2004;183:1093–1096
  28. Wittram C, Meehan MJ, Halpern EF, et al. Trends in thoracic radiology over a decade at a large academic medical center. J Thorac Imaging. 2004;19:164–170
  29. Goodman LR. Small pulmonary emboli: what do we know?. Radiology. 2005;234:654–658
  30. Rehani MM, Berry M. Radiation doses in computed tomography. BMJ. 2000;320:593–594
  31. Dixon AK, Coulden RAR, Peters AM. The non-invasive diagnosis of pulmonary embolus. BMJ. 2001;323:412–413
  32. Eaton L. UK agency reports slight increase in radiation exposure. BMJ. 2005;330:1229
  33. Abella HA. Report from NCRP: CT-based radiation exposure in U.S. population soars. http://www.diagnosticimaging.com/showNews.jhtml?articleID = 199100006) [accessed 24.05.2007].
  34. He H, Stein MW, Zalta BM, et al. CT evaluation of right heart dysfunction in patients with pulmonary embolism. J Comput Assist Tomogr. 2006;30:262–266
  35. Aaroz PA, Gotway MB, Harrington JR, et al. Pulmonary embolism: prognostic CT findings. Radiology. 2007;242:889–897
  36. Gottlieb RH. Imaging for whom: patient or physician?. AJR Am J Roentgenol. 2005;185:1399–1403
  37. Stein PD, Kayali F, Olson RE. Estimated case fatality rate of pulmonary embolism, 1979 to 1998. Am J Cardiol. 2004;93:1197–1199

PII: S0009-9260(07)00443-6

doi: 10.1016/j.crad.2007.10.004

Clinical Radiology
Volume 63, Issue 4 , Pages 381-386 , April 2008

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