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Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism

van Es, J., Douma, R. A., Hezemans, R. E. L., Penaloza, A., Motte, S., Erkens, P. G. M., Durian, M. F., van Eck-Smit, B. L. F. & Kamphuisen, P. W., Aug-2015, In : Thrombosis Research. 136, 2, p. 221-224 4 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

van Es, J., Douma, R. A., Hezemans, R. E. L., Penaloza, A., Motte, S., Erkens, P. G. M., ... Kamphuisen, P. W. (2015). Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism. Thrombosis Research, 136(2), 221-224. https://doi.org/10.1016/j.thromres.2015.05.018

Author

van Es, J. ; Douma, R. A. ; Hezemans, R. E. L. ; Penaloza, A. ; Motte, S. ; Erkens, P. G. M. ; Durian, M. F. ; van Eck-Smit, B. L. F. ; Kamphuisen, P. W. / Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism. In: Thrombosis Research. 2015 ; Vol. 136, No. 2. pp. 221-224.

Harvard

van Es, J, Douma, RA, Hezemans, REL, Penaloza, A, Motte, S, Erkens, PGM, Durian, MF, van Eck-Smit, BLF & Kamphuisen, PW 2015, 'Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism', Thrombosis Research, vol. 136, no. 2, pp. 221-224. https://doi.org/10.1016/j.thromres.2015.05.018

Standard

Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism. / van Es, J.; Douma, R. A.; Hezemans, R. E. L.; Penaloza, A.; Motte, S.; Erkens, P. G. M.; Durian, M. F.; van Eck-Smit, B. L. F.; Kamphuisen, P. W.

In: Thrombosis Research, Vol. 136, No. 2, 08.2015, p. 221-224.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

van Es J, Douma RA, Hezemans REL, Penaloza A, Motte S, Erkens PGM et al. Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism. Thrombosis Research. 2015 Aug;136(2):221-224. https://doi.org/10.1016/j.thromres.2015.05.018


BibTeX

@article{27083dcc683c47d9a2f4e9e393aa8faf,
title = "Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism",
abstract = "Background: Computed tomography pulmonary angiogram (CTPA) has become the standard test in the diagnostic workup of patients with suspected pulmonary embolism (PE). However, young patients may have an increased risk of cancer with CTPA. Perfusion scanning combined with chest X-ray (X/Q) may offer an adequate alternative, but has never been prospectively validated. We directly compared this strategy with CTPA in patients agedMethods: Consecutive patients with a likely clinical probability or an abnormal D-dimer level underwent both CTPA and X/Q. Two trained and experienced nuclear physicians independently analyzed the X/Q-scans. The accuracy of X/Q according to the PISAPED criteria was calculated in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results: Seventy-six patients were included, with a PE rate of 33{\%}. The inter-observer agreement for X/Q-scan reading was high (kappa = 0.89). After consensus reading, 21 patients (28{\%}) were categorized as 'PE present', 53 (70{\%}) as 'PE absent', and two (2.6{\%}) as 'non-diagnostic'. In 22{\%}, there was a discrepancy between the X/Q-scan and CPTA for the diagnosis or exclusion of PE. The PPV and NPV were 71{\%} and 83{\%}, respectively.Conclusion: In patients with a high risk of PE, a diagnostic strategy of chest X-ray and perfusion scanning using the PISAPED criteria seems less safe than CTPA. Additional studies should further investigate this diagnostic algorithm. (C) 2015 Elsevier Ltd. All rights reserved.",
keywords = "COMPUTED-TOMOGRAPHY, RADIATION-EXPOSURE, D-DIMER, ANGIOGRAPHY, CT, SCINTIGRAPHY, PROBABILITY, DIAGNOSIS",
author = "{van Es}, J. and Douma, {R. A.} and Hezemans, {R. E. L.} and A. Penaloza and S. Motte and Erkens, {P. G. M.} and Durian, {M. F.} and {van Eck-Smit}, {B. L. F.} and Kamphuisen, {P. W.}",
year = "2015",
month = "8",
doi = "10.1016/j.thromres.2015.05.018",
language = "English",
volume = "136",
pages = "221--224",
journal = "Thrombosis Research",
issn = "0049-3848",
publisher = "PERGAMON-ELSEVIER SCIENCE LTD",
number = "2",

}

RIS

TY - JOUR

T1 - Accuracy of X-ray with perfusion scan in young patients with suspected pulmonary embolism

AU - van Es, J.

AU - Douma, R. A.

AU - Hezemans, R. E. L.

AU - Penaloza, A.

AU - Motte, S.

AU - Erkens, P. G. M.

AU - Durian, M. F.

AU - van Eck-Smit, B. L. F.

AU - Kamphuisen, P. W.

PY - 2015/8

Y1 - 2015/8

N2 - Background: Computed tomography pulmonary angiogram (CTPA) has become the standard test in the diagnostic workup of patients with suspected pulmonary embolism (PE). However, young patients may have an increased risk of cancer with CTPA. Perfusion scanning combined with chest X-ray (X/Q) may offer an adequate alternative, but has never been prospectively validated. We directly compared this strategy with CTPA in patients agedMethods: Consecutive patients with a likely clinical probability or an abnormal D-dimer level underwent both CTPA and X/Q. Two trained and experienced nuclear physicians independently analyzed the X/Q-scans. The accuracy of X/Q according to the PISAPED criteria was calculated in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results: Seventy-six patients were included, with a PE rate of 33%. The inter-observer agreement for X/Q-scan reading was high (kappa = 0.89). After consensus reading, 21 patients (28%) were categorized as 'PE present', 53 (70%) as 'PE absent', and two (2.6%) as 'non-diagnostic'. In 22%, there was a discrepancy between the X/Q-scan and CPTA for the diagnosis or exclusion of PE. The PPV and NPV were 71% and 83%, respectively.Conclusion: In patients with a high risk of PE, a diagnostic strategy of chest X-ray and perfusion scanning using the PISAPED criteria seems less safe than CTPA. Additional studies should further investigate this diagnostic algorithm. (C) 2015 Elsevier Ltd. All rights reserved.

AB - Background: Computed tomography pulmonary angiogram (CTPA) has become the standard test in the diagnostic workup of patients with suspected pulmonary embolism (PE). However, young patients may have an increased risk of cancer with CTPA. Perfusion scanning combined with chest X-ray (X/Q) may offer an adequate alternative, but has never been prospectively validated. We directly compared this strategy with CTPA in patients agedMethods: Consecutive patients with a likely clinical probability or an abnormal D-dimer level underwent both CTPA and X/Q. Two trained and experienced nuclear physicians independently analyzed the X/Q-scans. The accuracy of X/Q according to the PISAPED criteria was calculated in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results: Seventy-six patients were included, with a PE rate of 33%. The inter-observer agreement for X/Q-scan reading was high (kappa = 0.89). After consensus reading, 21 patients (28%) were categorized as 'PE present', 53 (70%) as 'PE absent', and two (2.6%) as 'non-diagnostic'. In 22%, there was a discrepancy between the X/Q-scan and CPTA for the diagnosis or exclusion of PE. The PPV and NPV were 71% and 83%, respectively.Conclusion: In patients with a high risk of PE, a diagnostic strategy of chest X-ray and perfusion scanning using the PISAPED criteria seems less safe than CTPA. Additional studies should further investigate this diagnostic algorithm. (C) 2015 Elsevier Ltd. All rights reserved.

KW - COMPUTED-TOMOGRAPHY

KW - RADIATION-EXPOSURE

KW - D-DIMER

KW - ANGIOGRAPHY

KW - CT

KW - SCINTIGRAPHY

KW - PROBABILITY

KW - DIAGNOSIS

U2 - 10.1016/j.thromres.2015.05.018

DO - 10.1016/j.thromres.2015.05.018

M3 - Article

VL - 136

SP - 221

EP - 224

JO - Thrombosis Research

JF - Thrombosis Research

SN - 0049-3848

IS - 2

ER -

ID: 26773180