Seminars in Roentgenology
Volume 40, Issue 1 , Pages 20-24 , January 2005

CT pulmonary angiography for acute pulmonary embolism: Cost-effectiveness analysis and review of the literature

  • Rene Quiroz, MD, MPH

      Affiliations

    • Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
    • Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
    • ,
  • U. Joseph Schoepf, MD

      Affiliations

    • Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
    • Department of Radiology, Medical University of South Carolina, Charleston, SC, USA.
    • Corresponding Author InformationAddress reprint requests to: U. Joseph Schoepf, MD, Department of Radiology, Medical University of South Carolina, 169 Ashley Avenue, Charleston, SC 29425.

References 

  1. Schoepf UJ , Goldhaber SZ , Costello P . Spiral computed tomography for acute pulmonary embolism . Circulation . 2004;109(18):2160–2167
  2. Stein PD , Athanasoulis C , Alavi A , Greenspan RH , Hales CA , Saltzman HA , et al.   Complications and validity of pulmonary angiography in acute pulmonary embolism . Circulation . 1992;85(2):462–468
  3. Wells PS , Ginsberg JS , Anderson DR , Kearon C , Gent M , Turpie AG , et al.   Use of a clinical model for safe management of patients with suspected pulmonary embolism . Ann Intern Med . 1998;129(12):997–1005
  4. The PIOPED Investigators . Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED) . JAMA . 1990;263(20):2753–2759
  5. Perrier A , Desmarais S , Miron MJ , de Moerloose P , Lepage R , Slosman D , et al.   Non-invasive diagnosis of venous thromboembolism in outpatients . Lancet . 1999;353(9148):190–195
  6. Bounameaux H , de Moerloose P , Perrier A , Miron MJ . D-dimer testing in suspected venous thromboembolism (an update) . QJM . 1997;90(7):437–442
  7. Becker DM , Philbrick JT , Bachhuber TL , Humphries JE . D-dimer testing and acute venous thromboembolism. A shortcut to accurate diagnosis? . Arch Intern Med . 1996;156(9):939–946
  8. Oger E , Leroyer C , Bressollette L , Nonent M , Le Moigne E , Bizais Y , et al.   Evaluation of a new, rapid, and quantitative D-Dimer test in patients with suspected pulmonary embolism . Am J Respir Crit Care Med . 1998;158(1):65–70
  9. Bates SM , Grand’Maison A , Johnston M , Naguit I , Kovacs MJ , Ginsberg JS . A latex D-dimer reliably excludes venous thromboembolism . Arch Intern Med . 2001;161(3):447–453
  10. Turkstra F , Kuijer PM , van Beek EJ , Brandjes DP , ten Cate JW , Buller HR . Diagnostic utility of ultrasonography of leg veins in patients suspected of having pulmonary embolism . Ann Intern Med . 1997;126(10):775–781
  11. Perrier A , Bounameaux H , Morabia A , de Moerloose P , Slosman D , Didier D , et al.   Diagnosis of pulmonary embolism by a decision analysis-based strategy including clinical probability, D-dimer levels, and ultrasonography (a management study) . Arch Intern Med . 1996;156(5):531–536
  12. Hunink MG , Glasziou PP , Siegel JE , et al.   Decision Making in Health and Medicine (Integrating Evidence and Values) . Cambridge, UK: Cambridge Univ. Press; 2001;
  13. Kuntz KM , Fleischmann KE , Hunink MG , Douglas PS . Cost-effectiveness of diagnostic strategies for patients with chest pain . Ann Intern Med . 1999;130(9):709–718
  14. Hunink MG , Krestin GP . Study design for concurrent development, assessment, and implementation of new diagnostic imaging technology . Radiology . 2002;222(3):604–614
  15. Perrier A , Nendaz MR , Sarasin FP , Howarth N , Bounameaux H . Cost-effectiveness analysis of diagnostic strategies for suspected pulmonary embolism including helical computed tomography . Am J Respir Crit Care Med . 2003;167(1):39–44
  16. van Erkel AR , Pattynama PM . Cost-effective diagnostic algorithms in pulmonary embolism (an updated analysis) . Acad Radiol . 1998;5(Suppl. 2):S321–S327
  17. Paterson DI , Schwartzman K . Strategies incorporating spiral CT for the diagnosis of acute pulmonary embolism (a cost-effectiveness analysis) . Chest . 2001;119(6):1791–1800
  18. van Erkel AR , van Rossum AB , Bloem JL , Kievit J , Pattynama PM . Spiral CT angiography for suspected pulmonary embolism (a cost-effectiveness analysis) . Radiology . 1996;201(1):29–36
  19. Perrier A , Howarth N , Didier D , Loubeyre P , Unger PF , de Moerloose P , et al.   Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism . Ann Intern Med . 2001;135(2):88–97
  20. Gottschalk A , Stein PD , Goodman LR , Sostman HD . Overview of prospective investigation of pulmonary embolism diagnosis. II . Semin Nucl Med . 2002;32(3):173–182
  21. van Erkel AR , van den Hout WB , Pattynama PM . International differences in health care costs in Europe and the United States (do these affect the cost-effectiveness of diagnostic strategies for pulmonary embolism?) . Eur Radiol . 1999;9(9):1926–1931
  22. Hull RD , Raskob GE , Ginsberg JS , Panju AA , Brill-Edwards P , Coates G , et al.   A noninvasive strategy for the treatment of patients with suspected pulmonary embolism . Arch Intern Med . 1994;154(3):289–297
  23. van Rossum AB , Pattynama PM , Mallens WM , Hermans J , Heijerman HG . Can helical CT replace scintigraphy in the diagnostic process in suspected pulmonary embolism? A retrolective-prolective cohort study focusing on total diagnostic yield . Eur Radiol . 1998;8(1):90–96
  24. Garg K , Welsh CH , Feyerabend AJ , Subber SW , Russ PD , Johnston RJ , et al.   Pulmonary embolism (diagnosis with spiral CT and ventilationperfusion scanning—correlation with pulmonary angiographic results or clinical outcome) . Radiology . 1998;208(1):201–208
  25. Cham MD , Yankelevitz DF , Shaham D , Shah AA , Sherman L , Lewis A , et al.  The Pulmonary Angiography-Indirect CT Venography Cooperative Group   Deep venous thrombosis (detection by using indirect CT venography) . Radiology . 2000;216(3):744–751
  26. Loud PA , Katz DS , Bruce DA , Klippenstein DL , Grossman ZD . Deep venous thrombosis with suspected pulmonary embolism (detection with combined CT venography and pulmonary angiography) . Radiology . 2001;219(2):498–502
  27. Garg K , Kemp JL , Wojcik D , Hoehn S , Johnston RJ , Macey LC , et al.   Thromboembolic disease (comparison of combined CT pulmonary angiography and venography with bilateral leg sonography in 70 patients) . AJR Am J Roentgenol . 2000;175(4):997–1001
  28. Lipchik RJ , Goodman LR . Cost-effectiveness of computed tomography in diagnosis of pulmonary embolism . Am J Respir Crit Care Med . 2004;169(1):129; author reply: 129–130

PII: S0037-198X(04)00108-7

doi: 10.1053/j.ro.2004.09.007

Seminars in Roentgenology
Volume 40, Issue 1 , Pages 20-24 , January 2005

Article Tools

* Image Usage & Resolution