Elsevier

Academic Radiology

Volume 7, Issue 10, October 2000, Pages 786-797
Academic Radiology

2000 AUR Memorial Award
Accuracy of CT angiography versus pulmonary angiography in the diagnosis of acute pulmonary embolism: Evaluation of the literature with summary ROC curve analysis

https://doi.org/10.1016/S1076-6332(00)80626-1Get rights and content
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Rationale and Objectives.

The authors performed this study to estimate, by using published data, the sensitivity and specificity of computed tomographic (CT) angiography in the evaluation of suspected acute pulmonary embolism (PE).

Materials and Methods.

Summary receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of CT angiography in the diagnosis of acute PE. Pulmonary angiography was used as the diagnostic standard of reference. The authors reviewed the results of 11 independent studies published in the English-language literature between January 1992 and June 1999.

Results.

The sensitivity of CT angiography in the diagnosis or exclusion of PE in the central pulmonary arteries (to the level of the segmental pulmonary arteries) ranged from 0.74 to 0.81 on the basis of specificities of 0.89–0.91. The sensitivity of CT angiography in the diagnosis or exclusion of PE in all pulmonary arteries (to the level of the subsegmental pulmonary arteries) was 0.68 on the basis of a specificity of 0.91.

Conclusion.

On the basis of the studies in the current literature, most of which used 5.0-mm collimation and single-detector CT, CT angiography may be less accurate in the diagnosis of PE than previously reported. With improvements in data acquisition, particularly the use of thinner section collimation and multidetector CT, and in the increased use of workstations for data analysis, the accuracy and utility of CT angiography will require continued investigation.

Key Words

Computed tomography (CT), comparative studies
computed tomography (CT), helical
embolism, pulmonary
pulmonary angiography
pulmonary arteries, CT

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