Low-Probability Lung Scan Findings: A Need for Change
Authors: Russell D. Hull, Gary E. Raskob
Journal: Annals of Internal Medicine (1991)

Brief Reports15 January 1991Low-Probability Lung Scan Findings: A Need for ChangeRussell D. Hull, MBBS, MSc, Gary E. Raskob, MScRussell D. Hull, MBBS, MScSearch for more papers by this author, Gary E. Raskob, MScSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-2-142 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe sensitivity and specificity of Biello's (1) and Mc-Neil's (2) widely used criteria for the diagnosis of pulmonary embolism are unknown. These classic criteria are currently the basis for categorizing lung scan findings as being of high, intermediate, or low probability (1-4).Previous prospective studies, in which consecutive patients had pulmonary angiography, have been criticized for reporting predictive values without reporting sensitivity and specificity (5). The latter indices are independent of prevalence, whereas predictive values depend on prevalence and therefore are more influenced by the clinical setting in which the study is done. The Prospective Investigation of Pulmonary Embolism Diagnosis...References1. Biello D, Mattar A, McKnight R, and Siegel B. Ventilation-perfusion studies in suspected pulmonary embolism. AJR. 1979;133:1033-7 CrossrefMedlineGoogle Scholar2. McNeil B. Ventilation-perfusion studies and the diagnosis of pulmonary embolism. Concise communication. J Nucl Med. 1980;21:319-23. MedlineGoogle Scholar3. Alderson P, Rujanavech N, Secker-Walker R, and McKnight R. The role of 133Xe ventilation studies in the scintigraphic detection of pulmonary embolism. Radiology. 1976;120:633-40. CrossrefMedlineGoogle Scholar4. Cheely R, McCartney W, and Perry J. The role of non-invasive tests versus pulmonary angiography in the diagnosis of pulmonary embolism. Am J Med. 1981;70:17-22. CrossrefMedlineGoogle Scholar5. Hull R, Hirsh J, and Carter C. Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med. 1983;98:891-9. LinkGoogle Scholar6. Value of the ventilation-perfusion scan in acute pulmonary embolism: results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). JAMA. 1990;263:2753-9. CrossrefMedlineGoogle Scholar7. Hull R, Hirsh J, and Carter C. Diagnostic value of ventilation-perfusion lung scanning in patients with suspected pulmonary embolism. Chest. 1985;88:819-28. CrossrefMedlineGoogle Scholar8. Hull R, Raskob G, Coates G, and Panju A. Clinical validity of a normal perfusion lung scan in patients with suspected pulmonary embolism. Chest. 1990;97:23-6. CrossrefMedlineGoogle Scholar9. Moser K. Venous thromboembolism. Am Rev Respir Dis. 1990;141:235-49. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Russell D. Hull, MBBS, MSc; Gary E. Raskob, MScFrom the University of Calgary, Calgary, Alberta. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDiseases of the Pulmonary SystemObservations from PIOPED: ventilation-perfusion lung scans alone and in combination with clinical assessmentCriteria for very-low-probability interpretation of ventilation-perfusion lung scansContribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolismContribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolismPulmonary Embolism: Role of Ventilation-Perfusion ScintigraphyVenous Thrombosis and Pulmonary Thromboembolic DiseaseThe Current and Continuing Important Role of Ventilation-Perfusion Scintigraphy in Evaluating Patients With Suspected Pulmonary EmbolismHow chest CT for the diagnosis of pulmonary embolism (PE) has changed my professional life: Reflections from a PE doctorDiagnosis of pulmonary embolism with various imaging modalitiesA traditionally administered short course failed to improve medical students’ diagnostic performanceThe Added Value of Spiral Computed Tomographic Angiography After Lung Scintigraphy for the Diagnosis of Pulmonary EmbolismDiagnosis and Treatment of Pulmonary Embolism: An OverviewOverview of prospective investigation of pulmonary embolism diagnosis IIDiagnostic strategies for suspected pulmonary embolismEnhanced lung scan diagnosis of pulmonary embolism with the use of ancillary scintigraphic findings and clinical correlationLung Scintigraphy and Helical Computed Tomography for the Diagnosis of Pulmonary Embolism: A Meta-AnalysisNew Criteria for Ventilation-Perfusion Lung Scan Interpretation: A Basis for Optimal Interaction with Helical CT AngiographyScintigraphy-ventilation/perfusion scanning and imaging of the embolusReview of Criteria Appropriate for a Very Low Probability of Pulmonary Embolism on Ventilation-Perfusion Lung Scans: A Position PaperLower Extremity VenographyImaging evaluation of suspected pulmonary embolism2 Diagnostic management of venous thromboembolismCost-Effectiveness Analysis of Diagnostic Management of Pulmonary EmbolismVentilation/Perfusion Scan in the Diagnosis of Acute Pulmonary EmbolismOverview of Treatment of Venous Thromboembolism Based on Levels of EvidenceIntérêts et limites du couple scintigraphie pulmonaire/écho-doppler veineux dans la gestion de l'embolie pulmonaireClinical utilization of the non-diagnostic lung scintigramTHE EVALUATION OF DIAGNOSTIC TESTS: Principles, Problems, and New DevelopmentsRole of spiral volumetric computed tomographic scanning in the assessment of patients with clinical suspicion of pulmonary embolism and an abnormal ventilation/perfusion lung scan.Diagnóstico gammagráfico del tromboembolismo pulmonar agudoPULMONARY EMBOLISMPlace de l'imagerie isotopique en réanimationROLE OF RADIONUCLIDE IMAGING IN PATIENTS WITH SUSPECTED PULMONARY EMBOLISMIn replyVenous Thromboembolism in Spinal Cord Injury PatientsPulmonary angiography in a non‐teaching hospital over a 12‐year periodLung scanning in the diagnosis of pulmonary embolism: The emperor redressedDiagnosis of Pulmonary EmbolismJames F. Morris, MD, Gerbail T. Krishnamurthy, MD"Low-Probability" Ventilation-Perfusion ScansMartin P. Jacobs, MDImaging of Acute Pulmonary Embolism 15 January 1991Volume 114, Issue 2Page: 142-143KeywordsAngiographyHeartHospital medicineLungsProspective studiesPulmonary embolismSpecificityStroke ePublished: 1 December 2008 Issue Published: 15 January 1991 PDF downloadLoading ...