With regard to the use of contrast-enhanced helical computed tomography (CT) for the diagnosis of pulmonary embolism (PE), the ICSI Technology Assessment Committee finds:
- All forms of CT are safe.
- Conventional CT is not indicated in the diagnosis of PE.
- Contrast-enhanced helical CT has good diagnostic accuracy (sensitivity of 70% to 100%; specificity of 78% to 97%) and higher sensitivity and interobserver agreement than ventilation/perfusion (V/Q) scanning. Reported accuracies are highly dependent on proper technique and accurate assessment by experienced radiologists.
- Compared to pulmonary angiography (PA) and V/Q scanning, the reduced time required for and less invasive nature of contrast-enhanced helical CT would appear to be beneficial for the critically ill patient. For institutions with 24-hour expert interpretation of contrast-enhanced helical CT, full time access to helical CT may provide an advantage over other techniques.
- Information from CT led to alternative diagnoses in over 50% of patients (Conclusion Grade II).