Relative accuracy of two diagnostic schemes for detection of pulmonary embolism by ventilation-perfusion scintigraphy

• Published in: Radiology Vol. 145; no. 2; p. 447
• Main Authors: Carter, W D, Brady, T M, Keyes, Jr, J W, Thrall, J H, Greenhouse, J B, Biello, D R, Siegel, B A, Alderson, P O, Brady, T J
• Format: Journal Article
• Language: English
• Published: United States 01.11.1982
• Subjects: Angiography; Diatrizoate; Diatrizoate Meglumine; Humans; Pulmonary Embolism - diagnostic imaging; Radionuclide Imaging; Serum Albumin; Technetium; Technetium Tc 99m Aggregated Albumin; Ventilation-Perfusion Ratio; Xenon Radioisotopes
• ISSN: 0033-8419
• DOI: 10.1148/radiology.145.2.6215675

Two diagnostic schemes for detection of pulmonary embolism by ventilation-perfusion (V-P) scintigraphy were compared for relative accuracy by two groups of observers interpreting 70 V-P scintiscans. Observers in Group B, who used the criteria recently proposed by Biello et al., had a significantly smaller average number of "indeterminate" interpretations (41%) than did the observers in Group A (55%), who used a simpler scheme (p less than 0.05). In addition, Group B showed a slight improvement in positive predictive value without a deterioration in the negative predictive value compared with Group A. Along with this improvement in diagnostic performance, Group B achieved a significant reduction in interobserver variability compared with Group A for patients without pulmonary embolism (p less than 0.05). There was no significant difference in interobserver variability between the two groups for patients with pulmonary embolism. The diagnostic scheme introduced by Biello et al. represents a useful improvement for the diagnosis of pulmonary embolism by V-P imaging.