Accuracy of computed tomography angiography in the detection of pulmonary embolism in patients with high body weight |
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| Institution: | 1. Department of Anaesthesiology and Intensive Care, University of Debrecen, Clinical Centre, Nagyerdei krt. 98, Debrecen H-4012, Hungary;2. University Institute of Diagnostic, Interventional and Paediatric Radiology, Inselspital, University Hospital Bern, Freiburgstrasse 10, Bern CH-3010, Switzerland;3. Department of Radiology, University Hospital Basel, Petersgraben 4, Basel, CH-4031, Switzerland;4. Department of Radiology, University of Debrecen, Clinical Centre, Nagyerdei krt. 98, Debrecen H-4012, Hungary;5. Institute of Radiology, Hospital Centre of Biel, Vogelsang 84, Biel/Bienne CH-2501, Switzerland;1. IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, via Giuseppe La Masa 19, 20156 Milano, Italy;2. European Clinical Research Infrastructure Network, Biopark, 5-7 rue Watt 75013 Paris, France;3. The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark;4. Coordination Centre for Clinical Trials, Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf, Germany;1. Department of Paediatrics, University Magna Graecia of Catanzaro, Catanzaro, Italy;2. Graduate School in Teaching, University Roma Tre, Rome, Italy;3. Rare Metabolic Diseases Unit, Paediatric Clinic, San Gerardo Hospital, University Milano Bicocca, Monza, Italy;1. Internal Medicine Department, Hospital Virgen de la Luz, Cuenca, Spain;2. Biometrics Department, Phidea Marvin S.L.U., Madrid, Spain;1. Head Respiratory Medicine and Research Centre on Asthma and COPD, University of Ferrara, Ferrara, Italy;2. Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Cà Granda, Milano, Italy;3. Allergy and Respiratory Disease Clinic, University of Genova, Genova, Italy;4. Unit of Respiratory Clinical Pharmacology, Department of System Medicine, University of Rome Tor Vergata, Roma, Italy;5. Respiratory Unit, San Paolo Hospital, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy;6. Department of Medical and Surgical Sciences University of Foggia, Foggia, Italy;7. Respiratory Pathophysiology, Cardiothoracic Dept., University Hospital, Siena, Italy;8. Respiratory Pathophysiology and Rehabilitation Unit, Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy;9. Department of Clinical and Biological Sciences, University of Torino, Torino, Italy;10. Pulmonary Unit, Department of Medicine, University of Verona, Verona, Italy;11. Department of Medicine, Section of Pulmunology, University of Palermo, Palermo, Italy;1. U.O.C. di Gastroenterologia ed Endoscopia Digestiva “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy;2. S. A. di Endoscopia Digestiva e Gastroenterologia “Istituti Ospedalieri”, Cremona, Italy;3. U.O. di Gastroenterologia e Dietetica Clinica “S. Maria delle Croci”, Ravenna, Italy;4. U.O.C. di Gastroenterologia ed Endoscopia Digestiva “A.Maresca”, Torre del Greco, Naples, Italy;5. S.C. di Endoscopia Digestiva “S.Agostino — Estense”, Baggiovara, Modena, Italy;6. U.O.C. di Endoscopia Digestiva Chirurgica “A. Gemelli”, Rome, Italy;7. UOC di Gastroenterologia “S.Maria del Prato”, Feltre, Belluno, Italy;8. U.O.M. di Gastroenterologia ed Endoscopia Digestiva “Santa Maria del Carmine”, Rovereto, Trento, Italy;9. U.O. di Gastroenterologia ed Endoscopia Digestiva “San Paolo”, Bari, Italy;10. U.O.D. di Endoscopia Digestiva “Sant''Andrea”, Rome, Italy;11. S.C. di Gastroenterologia “S.Maria di Ca'' Fondello”, Treviso, Italy;12. U.O.C. di Endoscopia Digestiva Chirurgica “Sacro Cuore”, Campobasso, Italy;13. U.O.C. di Gatroenterologia ed Endoscopia Digestiva “L.Curto”, Polla e S.Arsenio, Salerno, Italy;14. S.C. di Gastroenterologia ed Endoscopia Digestiva “San Bassiano”, Bassano del Grappa, Vicenza, Italy;15. U.O.C. di Gastroenterologia ed Endoscopia Digestiva “San Gennaro”, Naples, Italy;16. U.O Gastroenterologia — Servizio di Endoscopia Digestiva “V. Cervello”, Palermo, Italy;17. U.O.S.D. di Gastroenterologia ed Endoscopia Digestiva “SS. Annunziata”, Chieti, Italy;18. S. C. di Gastroenterologia ed Endoscopia Digestiva “A.Manzoni”, Lecco, Italy;19. S.C. di Gastroenterologia 2 — A.O. Universitaria “San Giovanni Battista”, Turin, Italy;20. U.O.C. di Epato-Gastroenterologia — Unità di Endoscopia Digestiva “II° Policlinico”, Naples, Italy;21. U.O. Clinica Gastroenterologica con Endoscopia-Dipart. Medicina Interna “San Martino”, Genova, Italy;22. Gastroenterologia ed Endoscopia Digestiva “Ospedali Riuniti”, Foggia, Italy;23. U.O.C. di Gastroenterologia ed Endoscopia Digestiva “San Camillo de Lellis”, Rieti, Italy;1. Gastroenterology and Digestive Endoscopy, ‘Nuovo Regina Margherita’ Hospital, Rome, Italy;2. Department of Digestive and Liver Disease, Sant''Andrea Hospital, University Sapienza of Rome, Rome, Italy;3. Department of Gastroenterology and Digestive Endoscopy, “Casa Sollievo della Sofferenza” Hospital, IRCCS, San Giovanni Rotondo, Foggia, Italy;4. Gastroenterology, Maresca Hospital, Torre del Greco, Naples, Italy;5. Gastroenterology Unit ‘Riuniti’ Hospital, Foggia, Italy;6. Department of Gastroenterology, HHT Center, Maggiore Hospital, Crema, Italy |
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| Abstract: | BackgroundThe accuracy of CT pulmonary angiography (CTPA) in detecting or excluding pulmonary embolism has not yet been assessed in patients with high body weight (BW).MethodsThis retrospective study involved CTPAs of 114 patients weighing 75–99 kg and those of 123 consecutive patients weighing 100–150 kg. Three independent blinded radiologists analyzed all examinations in randomized order. Readers' data on pulmonary emboli were compared with a composite reference standard, comprising clinical probability, reference CTPA result, additional imaging when performed and 90-day follow-up. Results in both BW groups and in two body mass index (BMI) groups (BMI < 30 kg/m2 and BMI ≥ 30 kg/m2, i.e., non-obese and obese patients) were compared.ResultsThe prevalence of pulmonary embolism was not significantly different in the BW groups (P = 1.0). The reference CTPA result was positive in 23 of 114 patients in the 75–99 kg group and in 25 of 123 patients in the ≥ 100 kg group, respectively (odds ratio, 0.991; 95% confidence interval, 0.501 to 1.957; P = 1.0). No pulmonary embolism-related death or venous thromboembolism occurred during follow-up. The mean accuracy of three readers was 91.5% in the 75–99 kg group and 89.9% in the ≥ 100 kg group (odds ratio, 1.207; 95% confidence interval, 0.451 to 3.255; P = 0.495), and 89.9% in non-obese patients and 91.2% in obese patients (odds ratio, 0.853; 95% confidence interval, 0.317 to 2.319; P = 0.816).ConclusionThe diagnostic accuracy of CTPA in patients weighing 75–99 kg or 100–150 kg proved not to be significantly different. |
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