Bottom line: Close to 20% of patients with negative chest CT will have a pulmonary embolism.
Summary: Stein PD, et al. Multidetector Computed Tomography for Acute Pulmonary Embolism [PIOPED II]. New Engl J Med. 2006; 354: 2317-2327.
Prospective study of 1,090 adults with suspected pulmonary embolism. All patients received Wells scoring; MDCTA of chest alone and combined with venous-phase imaging of pelvic and thigh veins (CT angiography-CT venography [CTA-CTV]) using 4-row, 8-row, or 16-row multidetector scanners; ventilation-perfusion scanning; venous compression ultrasound of lower extremities; pulmonary digital-subtraction angiography if noninvasive tests were inconclusive.
Reference standard was composite of Wells score, MDCTA of chest, VQ scan, ultrasound, and pulmonary digital-subtraction angiography with 6 month follow up.
RESULTS: CTA had 83% sensitivity and 96% specificity.
Study identified in DynaMed Pulmonary Embolism summary.