Scanning Systems and Protocols Used During Imaging for Acute Pulmonary Embolism: How Much Do Our Clinical Colleagues Know?

Scatarige, John C.; Weiss, Clifford R.; Diette, Gregory B.; Haponik, Edward F.; Merriman, Barry; Fishman, Elliot K.

doi:10.1016/j.acra.2006.02.032

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Volume 13, Issue 6 , Pages 678-685, June 2006

Scanning Systems and Protocols Used During Imaging for Acute Pulmonary Embolism:

How Much Do Our Clinical Colleagues Know?

John C. Scatarige, MD
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 N Caroline Street, Room 3254
Clifford R. Weiss, MD
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 N Caroline Street, Room 3254
- Address correspondence to: C.R.W.
Gregory B. Diette, MD, MHS
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287-0801
Edward F. Haponik, MD
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287-0801
Barry Merriman, MA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287-0801
Elliot K. Fishman, MD
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 N Caroline Street, Room 3254

Received 6 January 2006; received in revised form 5 February 2006; accepted 7 February 2006.

Rationale and Objectives

The imaging systems and protocols used during ventilation-perfusion lung (V-P) scintigraphy and computed tomographic (CT) pulmonary angiography (CTPA) can affect diagnostic performance. We investigated the level of awareness of these factors among US clinicians who refer patients for imaging for suspected acute pulmonary embolism.

Materials and Methods

Between September 2004 and February 2005, we conducted a mail survey of 855 physicians selected at random from three professional organizations. We asked participants how important the availability of state-of-the-art equipment was in their imaging decisions, whether V-P scintigraphy was performed with planar or single-photon emission CT (SPECT) equipment in their communities, to identify the most advanced type of CT scanner used for CTPA, and whether CT venography (CTV) was performed routinely after CTPA.

Results

We received completed surveys from 240 (29.8%) physicians practicing in 44 states. One hundred sixty-six respondents (70.9%) indicated that state-of-the-art equipment was an extremely or very important factor when they made imaging decisions. However, 191 clinicians (80.3%) did not know whether SPECT equipment was used for V-P scintigraphy, and 119 (50.6%) did not know the type of CT scanner used for CTPA in their communities. Of respondents, 39.2% reported access to multidetector row CT technology for CTPA, whereas 10.2% referred patients to facilities using single-detector CT. Only 9.3% of respondents indicated that CTV was performed routinely after CTPA.

Conclusion

Although state-of-the-art equipment is important to them, clinicians practicing in the United States have limited knowledge of the equipment being used during CTPA and V-P scintigraphy scanning in their communities. Radiologists should intensify efforts to familiarize their clinical colleagues with the equipment they use.

Key Words: Acute Pulmonary Embolism , Computed Tomographic Pulmonary Angiography , Computed Tomography , Computed Tomographic Vernography , Multidetector Computed Tomography , Ventilation-Perfusion Scintigraphy , SPECT , Imaging Technology , Imaging Equipment , Awareness , Survey