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CT Pulmonary Angiography

Department of Radiology
Hospital Santiago Apóstol
Olaguíbel, 29
01004 Vitoria, Spain

Soledad Alvarez

Department of Nuclear Medicine
Hospital Santiago Apóstol
Olaguíbel, 29
01004 Vitoria, Spain

We read with great interest the article by Prologo et al. [1] in the October 2004 issue of the AJR in which they describe a notable increase in the number of CT pulmonary angiographies requested by the emergency department. This increase curiously enough has not been accompanied by a variation in the total number of patients diagnosed by CT pulmonary angiography as having pulmonary embolism, a figure which is very similar to that reported 5 years earlier. This has meant a considerable decrease in the prevalence of pulmonary embolism in the patients studied.

We do not know whether the emergency department of their hospital has undergone changes in protocols regarding clinical management, patient origin, and so forth, which might account for such an increase. Apparently, however, an examination that should be used as a diagnostic tool when pulmonary embolism is suspected is being used in an incorrect, large-scale, and urgent manner as a screening tool for thoracic pathology. In spite of this, the prevalence of these other disorders also has diminished. This indicates that there have been a large number of patients in whom an unnecessary examination has been carried out, with a far from negligible dose of radiation. In the case of pulmonary embolism, it already has been demonstrated how the possibility of employing new diagnostic methods leads to greater use not only of such new methods but also of other diagnostic procedures [2].

The data in the article by Prologo et al. [1] suggest that a further effort should be made to better determine the clinical indications for CT pulmonary angiography.

References

1. Prologo JD, Gilkeson RC, Diaz M, Asaad J. CT pulmonary angiography: a comparative analysis of the utilization patterns in emergency department and hospitalized patients between 1998 and 2003. AJR2004; 183:1093 -1096[Abstract/Free Full Text]
2. Goldstein NM, Kollef MH, Ward S, Gage BF. The impact of the introduction of a rapid D-dimer assay on the diagnostic evaluation of suspected pulmonary embolism. Arch Intern Med2001; 161:567 -571[Abstract/Free Full Text]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Añorbe, E. Articles by Alvarez, S. Search for Related Content PubMed PubMed Citation Articles by Añorbe, E. Articles by Alvarez, S. Social Bookmarking                      What's this?