Examples of application perfusion pulmonary scintigraphy in assessing treatment efficacy artery pulmonary embolism

The study was aimed at evaluating role of CT Pulmonary Angiography (CTPA) and Indirect CT venography (ICTV) in clinically suspected pulmonary embolism (PE) in oncology setup.17/31 (54.9%) patients were diagnosed with PE with or without deep vein thrombosis. DVT was diagnosed in 12(38.7%). 1 patient had DVT in absence of PE while 13/31 (41.9%) patients were diagnosed not to have PE or DVT. Clinical symptoms or pre-test probability determined by Well’s criteria and other laboratory investigations were not found predictive of PE. CTPA diagnosed PE with greater ease, shorter time required with no dependence on clinical pretest probability unlike pulmonary scintigraphy. In cases with CTPA negative for PE, CT described additional findings possibly explaining patient’s presenting symptoms unlike negative pulmonary scintigraphy. In cases where PE was excluded, CTV identified DVT (if present) in the same sitting, obviating separate venous Doppler. A single investigation with ability to deal with complete spectrum of DVT and PE makes CTPA & ICTV ‘one stop shop’ imaging modality for PE and DVT. Nepalese Journal of Radiology / Vol.3 / No.1 / Issue 4 / Jan-June, 2013 / 40-52 DOI: http://dx.doi.org/10.3126/njr.v3i1.8795

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Massive Pulmonary Embolism Presenting as Complete Unilateral Absence of Lung Perfusion on Pulmonary Scintigraphy

Clinical Nuclear Medicine ◽

10.1097/00003072-200301000-00008 ◽

2003 ◽

Vol 28 (1) ◽

pp. 34-36

Author(s):

NIR HOD ◽

AMIR PEER ◽

LILIA MINDLIN ◽

YORAM RAMOT ◽

AMIT VAZINA ◽

...

Keyword(s):

Pulmonary Embolism ◽

Massive Pulmonary Embolism ◽

Lung Perfusion ◽

Pulmonary Scintigraphy

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Influence of Thrombophilia on the Efficacy of Dabigatran Versus Warfarin for the Extended Treatment of Acute Venous Thromboembolism in RE-MEDY™

Blood ◽

10.1182/blood.v124.21.1544.1544 ◽

2014 ◽

Vol 124 (21) ◽

pp. 1544-1544 ◽

Cited By ~ 5

Author(s):

Sam Schulman ◽

Henry Eriksson ◽

Samuel Z. Goldhaber ◽

Ajay Kakkar ◽

Clive Kearon ◽

...

Keyword(s):

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Treatment Efficacy ◽

Research Funding ◽

Factor V Leiden ◽

Factor V ◽

Total Study Population ◽

Extended Treatment ◽

Advisory Boards ◽

Bayer Healthcare

Abstract Background: Dabigatran etexilate (DE) was noninferior to warfarin for the prevention of recurrent venous thromboembolism (VTE), with a lower risk of bleeding, when administered as extended treatment for VTE in the RE-MEDY™ study (in which we evaluated long-term extension of treatment with dabigatran compared with warfarin). Objectives: Thrombophilia is a major risk factor for VTE recurrence. Therefore, we performed a post-hocsubgroup analysis on data from RE-MEDY™ to investigate the efficacy of DE versus warfarin in patients with and without thrombophilia (congenital or acquired) at baseline. Methods: Patients were aged ≥ 18 years and had objectively-confirmed, symptomatic, proximal deep vein thrombosis or pulmonary embolism (PE) that had been treated with an approved anticoagulant for 3–12 months, or with DE in one of two clinical trials of treatment for acute VTE (RE-COVER™ or RE-COVER™ II). Eligible patients were those at increased risk for recurrent VTE. Patients were randomly allocated to receive DE 150 mg twice daily or warfarin (international normalized ratio range 2.0–3.0) for 6–36 months. The primary efficacy outcome was recurrent, symptomatic, objectively-confirmed VTE or VTE-related death from randomization up to the end of the planned treatment period (6–36 months). No thrombophilia workup was required for enrollment in the trial. Results: Overall, 262/1430 (18.3%) patients randomized to DE and 263/1426 (18.4%) randomized to warfarin had thrombophilia identified at baseline. Factor V Leiden thrombophilia was the most common type (Table). The frequencies of VTE/VTE-related deaths, and of PE, in patients with and without thrombophilia are shown in the Table. Treatment efficacy (DE versus warfarin) was not significantly affected by the presence of thrombophilia. Table DE (n = 1430) Warfarin (n = 1426) Thrombophilia, n (%) No 433 (30.3) 407 (28.5) Yes 262 (18.3) 263 (18.4) Factor V Leiden 131 (9.2) 137 (9.6) Prothrombin mutation 35 (2.4) 28 (2.0) Antithrombin deficiency 11 (0.8) 11 (0.8) Protein C/S deficiencies 25 (1.7) 29 (2.0) Antiphospholipid antibodies and/or lupus anticoagulants 38 (2.7) 54 (3.8) Not tested 735 (51.4) 756 (53.0) VTE/VTE-related deaths, n/N (%) Pulmonary embolism, n/N (%) DE Warfarin DE Warfarin Thrombophilia No 10/433 (2.3) 3/407 (0.7) 3/433 (0.7) 1/407 (0.2) Yes 4/262 (1.5) 6/263 (2.3) 3/262 (1.1) 2/263 (0.8) Not tested 12/735 (1.6) 9/756 (1.2) 4/735 (0.5) 2/756 (0.3) Total study population: Hazard ratio (DE vs warfarin) (95% confidence interval) 1.43 (0.78, 2.61) 1.97 (0.67, 5.76) Treatment (DE vs warfarin) by thrombophilia interaction p = 0.2277 p = 0.9003 p-value from Chi-square test for overall factor effect. Full analysis set. Conclusions: The frequencies of VTE/VTE-related death, and of PE, were similar for DE and warfarin in patients with thrombophilia who were receiving extended treatment for VTE. Treatment efficacy was not affected by the presence of thrombophilia. Disclosures Schulman: Boehringer Ingelheim: Consultancy, Honoraria, Research Funding; Bayer HealthCare: Consultancy, Honoraria, Research Funding. Eriksson:Boehringer Ingelheim: Consultancy; BMS: Consultancy; Pfizer: Consultancy. Goldhaber:Boehringer Ingelheim: Consultancy; Daiichi: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Janssen: Consultancy; Merck: Consultancy; Pfizer: Consultancy; Portola: Consultancy; Sanofi-Aventis: Consultancy. Kakkar:Boehringer Ingelheim: Consultancy, Honoraria, Research Funding; Pfizer: Consultancy, Honoraria, Research Funding; BMS: Consultancy, Honoraria, Research Funding; Daiichi: Consultancy, Honoraria, Research Funding; Bayer: Consultancy, Honoraria, Research Funding; Sanofi: Consultancy, Honoraria, Research Funding; Eisai: Consultancy, Honoraria, Research Funding. Kearon:Bayer Healthcare: Consultancy; Boehringer Ingelheim (Canada): Consultancy. Schellong:Boehringer Ingelheim: advisory boards Other, Consultancy, Honoraria; Bayer Healthcare: advisory boards, advisory boards Other, Consultancy, Honoraria; Daiichi Sankyo: advisory boards, advisory boards Other, Honoraria; BMS/Pfizer: Honoraria. Feuring:Boehringer Ingelheim: Employment. Friedman:Boehringer Ingelheim: Consultancy. Kreuzer:Boehringer Ingelheim: Employment.

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Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France

Journal of Nuclear Medicine ◽

10.2967/jnumed.115.157743 ◽

2015 ◽

Vol 56 (8) ◽

pp. 1212-1217 ◽

Cited By ~ 17

Author(s):

P.-Y. Le Roux ◽

M. Pelletier-Galarneau ◽

R. De Laroche ◽

M. S. Hofman ◽

L. S. Zuckier ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Pulmonary Scintigraphy ◽

Current Practices

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Pulmonary scintigraphy and fatal pulmonary embolism

Clinical Radiology ◽

10.1016/s0009-9260(85)80273-7 ◽

1985 ◽

Vol 36 (6) ◽

pp. 659

Keyword(s):

Pulmonary Embolism ◽

Fatal Pulmonary Embolism ◽

Pulmonary Scintigraphy

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Pulmonary scintigraphy in suspected pulmonary embolism: How often does it change clinical management?

Australasian Radiology ◽

10.1111/j.1440-1673.1994.tb00144.x ◽

1994 ◽

Vol 38 (2) ◽

pp. 97-98

Author(s):

P G WHITE ◽

G R J SISSONS ◽

M W J HAYWARD

Keyword(s):

Pulmonary Embolism ◽

Clinical Management ◽

Suspected Pulmonary Embolism ◽

Pulmonary Scintigraphy

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The Predictive Value of Cell Blood Count Parameters to Diagnose Pulmonary Embolism in Patients with SARS-CoV-2 Infection: A Case Control Study

Antibiotics ◽

10.3390/antibiotics11010060 ◽

2022 ◽

Vol 11 (1) ◽

pp. 60

Author(s):

Alessio Strazzulla ◽

Sarra Abroug Ben Halima ◽

Ibrahim Chouchane ◽

Marwa Rezek ◽

Marcella Pinto Stiebler ◽

...

Keyword(s):

Pulmonary Embolism ◽

Blood Count ◽

Case Control Study ◽

Univariate Analysis ◽

Case Control ◽

Lymphocyte Ratio ◽

Pulmonary Scintigraphy ◽

Significant Difference ◽

Control Study

Introduction: Acute pulmonary embolism (aPE) is frequently associated with coronavirus infectious disease-2019 (COVID-19) with an incidence of more than 16%. Among the new promising biomarkers of aPE, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) showed correlations with aPE prognosis. The aim of this study was to conduct an exploratory analysis to check the possible role of cell blood count (CBC) parameters as diagnostic and prognostic biomarkers of aPE in COVID-19 patients. Materials and Methods: A case control study was conducted. Two populations were compared: (i) patients hospitalised from 31 January 2020 to 30 June 2021 with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection and aPE confirmed at angio computed tomography (aCT) or pulmonary scintigraphy (COVID-19 aPE group); (ii) patients hospitalised from 31 January 2017 to 30 June 2021 without SARS-CoV-2 infection whose suspicion of aPE was excluded by aCT or pulmonary scintigraphy (no-aPE group). Results: Overall, 184 patients were included in the study, 83 in COVID-19 aPE group and 101 in no-aPE group. At the univariate analysis, COVID-19 patients with aPE had higher NLR, PLR, neutrophil and lymphocyte counts than patients without aPE (p < 0.05). No significant difference was found in mean platelet volume and platelet counts. No difference in mortality rate was detected. At the multivariate analysis, neutrophil and lymphocyte counts were both associated with diagnostic of aPE while no CBC parameters were associated with mortality at day#7. Conclusions: Neutrophiland lymphocyte counts could be predictors of the early detection of aPE in COVID-19 patients. The value of CBC indices as biomarkers of aPE in daily clinical practice needs to be investigated in further studies.

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