State-of-the-Art Imaging for the Evaluation of Pulmonary Embolism

go back to reference Stein P, Fowler S, Goodman L, Gottschalk A, Hales C, Hull R, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354:2317–27. Stein P, Fowler S, Goodman L, Gottschalk A, Hales C, Hull R, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354:2317–27.

go back to reference Winer-Muram H, Rydberg J, Johnson M, Tarver R, Williams M, Shah H, et al. Suspected acute pulmonary embolism: evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography. Radiology. 2004;233:806–15.CrossRefPubMed Winer-Muram H, Rydberg J, Johnson M, Tarver R, Williams M, Shah H, et al. Suspected acute pulmonary embolism: evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography. Radiology. 2004;233:806–15.CrossRefPubMed

go back to reference Remy-Jardin M, Pistolesi M, Goodman L, Gefter W, Gottschalk A, Mayo J, et al. Management of Suspected Acute Pulmonary Embolism in the era of CT angiography: a statement from the Fleischner Society. Radiology. 2007;245:315–29.CrossRefPubMed Remy-Jardin M, Pistolesi M, Goodman L, Gefter W, Gottschalk A, Mayo J, et al. Management of Suspected Acute Pulmonary Embolism in the era of CT angiography: a statement from the Fleischner Society. Radiology. 2007;245:315–29.CrossRefPubMed

go back to reference • Van Der Huller T, Van Es N, den Exter PL, Van Es J, ICM M, Douma RA, et al. Is a normal computed tomography pulmonary angiography safe to rule out acute pulmonary embolism in patients with a likely clinical probability? A patient-level meta-analysis. Thromb Haemost. 2017;117(8):1622–9. This large meta-analysis demonstrated that a negative CTPA can be used safely as a stand-alone test to exclude PE in patients with high clinical probability, with long-term incidence of venous thromboembolism and fatal PE after a negative scan that are comparable to patients with normal catheter based pulmonary angiography. This study further solidifies CT as the current gold standard for PE imaging.CrossRef • Van Der Huller T, Van Es N, den Exter PL, Van Es J, ICM M, Douma RA, et al. Is a normal computed tomography pulmonary angiography safe to rule out acute pulmonary embolism in patients with a likely clinical probability? A patient-level meta-analysis. Thromb Haemost. 2017;117(8):1622–9. This large meta-analysis demonstrated that a negative CTPA can be used safely as a stand-alone test to exclude PE in patients with high clinical probability, with long-term incidence of venous thromboembolism and fatal PE after a negative scan that are comparable to patients with normal catheter based pulmonary angiography. This study further solidifies CT as the current gold standard for PE imaging.CrossRef

go back to reference Robert-Ebadi H, Glauser F, Planquette B, Moumneh T, Le Gal G, Righini M. Safety of multidetector computed tomography pulmonary angiography to exclude pulmonary embolism in patients with a likely pretest clinical probability. Thromb Haemost. 2017;15:1584–90.CrossRef Robert-Ebadi H, Glauser F, Planquette B, Moumneh T, Le Gal G, Righini M. Safety of multidetector computed tomography pulmonary angiography to exclude pulmonary embolism in patients with a likely pretest clinical probability. Thromb Haemost. 2017;15:1584–90.CrossRef

go back to reference Schissler A, Rozenshtein A, Schluger N, Einstein A. National trends in emergency room diagnosis of pulmonary embolism, 2001–2010: a cross-sectional study. Respir Res. 2015;16:44.CrossRefPubMedPubMedCentral Schissler A, Rozenshtein A, Schluger N, Einstein A. National trends in emergency room diagnosis of pulmonary embolism, 2001–2010: a cross-sectional study. Respir Res. 2015;16:44.CrossRefPubMedPubMedCentral

go back to reference Smith-Bindman R, Lipson J, Marcus R, Kim KP, Mahesh M, Gould R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med. 2009;169(22):2078–86.CrossRefPubMedPubMedCentral Smith-Bindman R, Lipson J, Marcus R, Kim KP, Mahesh M, Gould R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med. 2009;169(22):2078–86.CrossRefPubMedPubMedCentral

go back to reference Jun M, Lix L, Durand M, Dahl M, Paterson M, Dormuth C, et al. Comparative safety of direct oral anticoagulants and warfarin in venous thromboembolism: multicentre, population based, observational study. BMJ. 2017;359:j4323. 1–8 Jun M, Lix L, Durand M, Dahl M, Paterson M, Dormuth C, et al. Comparative safety of direct oral anticoagulants and warfarin in venous thromboembolism: multicentre, population based, observational study. BMJ. 2017;359:j4323. 1–8

go back to reference Burge AJ, Freeman KD, Klapper PJ, Haramati LB. Increased diagnosis of pulmonary embolism without a corresponding decline in mortality during the CT era. Clin Radiol. 2008;63:381–6.CrossRefPubMed Burge AJ, Freeman KD, Klapper PJ, Haramati LB. Increased diagnosis of pulmonary embolism without a corresponding decline in mortality during the CT era. Clin Radiol. 2008;63:381–6.CrossRefPubMed

go back to reference Wiener RS, Schwartz LM, Woloshin S, et al. When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found. BMJ. 2013;347:f3368. 1–7 Wiener RS, Schwartz LM, Woloshin S, et al. When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found. BMJ. 2013;347:f3368. 1–7

go back to reference Kearon C, Akl E, Ornelas J, Blaivas S, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease CHEST guideline and expert panel report. CHEST. 2016;149(2):315–52.CrossRefPubMed Kearon C, Akl E, Ornelas J, Blaivas S, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease CHEST guideline and expert panel report. CHEST. 2016;149(2):315–52.CrossRefPubMed

go back to reference Linkins LA, Lapner ST. Review of D-dimer testing: good, bad, and ugly. Int J Lab Hem. 2017;39(Suppl. 1):98–103.CrossRef Linkins LA, Lapner ST. Review of D-dimer testing: good, bad, and ugly. Int J Lab Hem. 2017;39(Suppl. 1):98–103.CrossRef

go back to reference Schouten H, Geersing GJ, Koek HL, Zuithoff N, Janssen K, Douma R, et al. Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. BMJ. 2013;346:f2492. 1–13 Schouten H, Geersing GJ, Koek HL, Zuithoff N, Janssen K, Douma R, et al. Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. BMJ. 2013;346:f2492. 1–13

go back to reference Van Es N, Van Der Hulle T, Buler HR, Klok FA, Huisman MV, Galipienzo J, et al. Is stand-alone D-dimer testing safe to rule out acute pulmonary embolism. Thromb Haemost. 2016;15:323–8. Van Es N, Van Der Hulle T, Buler HR, Klok FA, Huisman MV, Galipienzo J, et al. Is stand-alone D-dimer testing safe to rule out acute pulmonary embolism. Thromb Haemost. 2016;15:323–8.

go back to reference Harringa J, Bracken R, Nagle S, Schiebler M, Pulia M, Svenson J, et al. Negative D-dimer testing excludes pulmonary embolism in non-high risk patients in the emergency department. Emerg Radiol. 2017;24:273–80.CrossRefPubMedPubMedCentral Harringa J, Bracken R, Nagle S, Schiebler M, Pulia M, Svenson J, et al. Negative D-dimer testing excludes pulmonary embolism in non-high risk patients in the emergency department. Emerg Radiol. 2017;24:273–80.CrossRefPubMedPubMedCentral

go back to reference Seeliger E, Sendeski M, Rihal CS, Persson P. Contrast-induced kidney injury: mechanisms, risk factors, and prevention. Eur Heart J. 2012;33:2007–15.CrossRefPubMed Seeliger E, Sendeski M, Rihal CS, Persson P. Contrast-induced kidney injury: mechanisms, risk factors, and prevention. Eur Heart J. 2012;33:2007–15.CrossRefPubMed

go back to reference Szucs-Farkas Z, Schibler F, Cullmann J, Torrente J, Patak M, Raible S, et al. Diagnostic accuracy of pulmonary CT angiography at low tube voltage: intraindividual comparison of a normal-dose protocol at 120 kVp and a low-dose protocol at 80 kVp using reduced amount of contrast medium in a simulation study. AJR. 2011;197:852–9.CrossRef Szucs-Farkas Z, Schibler F, Cullmann J, Torrente J, Patak M, Raible S, et al. Diagnostic accuracy of pulmonary CT angiography at low tube voltage: intraindividual comparison of a normal-dose protocol at 120 kVp and a low-dose protocol at 80 kVp using reduced amount of contrast medium in a simulation study. AJR. 2011;197:852–9.CrossRef

go back to reference Hu X, Ma L, Zhang J, Li Z, Shen Y, Hu D. Use of pulmonary CT angiography with low tube voltage and low iodine- concentration contrast agent to diagnose pulmonary embolism. Sci Rep. 2017;7(12741):1–8. Hu X, Ma L, Zhang J, Li Z, Shen Y, Hu D. Use of pulmonary CT angiography with low tube voltage and low iodine- concentration contrast agent to diagnose pulmonary embolism. Sci Rep. 2017;7(12741):1–8.

go back to reference Meyer M, Haubenreisser H, Schabel C, Leidecker C, Schmidt B, Schoenberg S, et al. CT pulmonary angiography in patients with acute or chronic renal insufficiency: evaluation of a low dose contrast material protocol. Sci Rep. 1995;2018(8):1–9. Meyer M, Haubenreisser H, Schabel C, Leidecker C, Schmidt B, Schoenberg S, et al. CT pulmonary angiography in patients with acute or chronic renal insufficiency: evaluation of a low dose contrast material protocol. Sci Rep. 1995;2018(8):1–9.

go back to reference Padole A, Deedar R, Khawaja A, Kalra M, Singh S. CT radiation dose and iterative reconstruction techniques. AJR. 2015;204:W384–92.CrossRefPubMed Padole A, Deedar R, Khawaja A, Kalra M, Singh S. CT radiation dose and iterative reconstruction techniques. AJR. 2015;204:W384–92.CrossRefPubMed

go back to reference Gharbi S, Labidi S, Mars M, Chelli M, Meftah S, Ladeb MF. Assessment of organ dose and image quality in head and chest CT examinations: a phantom study. J Radiol Prot. 2018;38:807–18.CrossRefPubMed Gharbi S, Labidi S, Mars M, Chelli M, Meftah S, Ladeb MF. Assessment of organ dose and image quality in head and chest CT examinations: a phantom study. J Radiol Prot. 2018;38:807–18.CrossRefPubMed

go back to reference Sauter A, Koehler T, Fingerle A, Brendel B, Richter V, Rasper M, et al. Ultra low dose CT pulmonary angiography with iterative reconstruction. PLoS One. 2016;11(9):e0162716. 1–9 Sauter A, Koehler T, Fingerle A, Brendel B, Richter V, Rasper M, et al. Ultra low dose CT pulmonary angiography with iterative reconstruction. PLoS One. 2016;11(9):e0162716. 1–9

go back to reference Bates D, Tkacz J, LeBedis C, Holalkere N. Suboptimal CT pulmonary angiography in the emergency department: a retrospective analysis of outcomes in a large academic medical center. Emerg Radiol. 2016;23:603–7.CrossRefPubMed Bates D, Tkacz J, LeBedis C, Holalkere N. Suboptimal CT pulmonary angiography in the emergency department: a retrospective analysis of outcomes in a large academic medical center. Emerg Radiol. 2016;23:603–7.CrossRefPubMed

go back to reference Damm R, Mohnike K, Gazis A, Rogits B, Seidensticker M, Ricke J, et al. Improvement of contrast media enhancement in CTA evaluating pulmonary embolism by utilizing ‘delayed’ bolus tracking in the descending aorta. Pol J Radiol. 2016;81:422–7. Damm R, Mohnike K, Gazis A, Rogits B, Seidensticker M, Ricke J, et al. Improvement of contrast media enhancement in CTA evaluating pulmonary embolism by utilizing ‘delayed’ bolus tracking in the descending aorta. Pol J Radiol. 2016;81:422–7.

go back to reference Hsua K, Levsky J, Haramati L, Gohari A. Performance of a simple robust empiric timing protocol for CT pulmonary angiography. Clin Imaging. 2018;48:17–21.CrossRef Hsua K, Levsky J, Haramati L, Gohari A. Performance of a simple robust empiric timing protocol for CT pulmonary angiography. Clin Imaging. 2018;48:17–21.CrossRef

go back to reference Shumana W, Leipsicb J, Buseya J, Green D, Pipavatah S, Hague C, et al. Prospectively ECG gated CT pulmonary angiography versus helical ungated CT pulmonary angiography: impact on cardiac related motion artifacts and patient radiation dose. Eur J Radiol. 2012;81:2444–9.CrossRef Shumana W, Leipsicb J, Buseya J, Green D, Pipavatah S, Hague C, et al. Prospectively ECG gated CT pulmonary angiography versus helical ungated CT pulmonary angiography: impact on cardiac related motion artifacts and patient radiation dose. Eur J Radiol. 2012;81:2444–9.CrossRef

go back to reference Doğan H, Kroft L, Huisman M, Van Der Geest R, Li Y, Lamb H, et al. Assessment of right ventricular function in acute pulmonary embolism using ECG-synchronized MDCT. AJR. 2010;195:909–15.CrossRefPubMed Doğan H, Kroft L, Huisman M, Van Der Geest R, Li Y, Lamb H, et al. Assessment of right ventricular function in acute pulmonary embolism using ECG-synchronized MDCT. AJR. 2010;195:909–15.CrossRefPubMed

go back to reference Liang HW, Zhao DL, Liu XD, Chen P, Zhou HT, Zhao CL, et al. ECG-gated pulmonary artery CTA for evaluation of right ventricular function in patients with acute pulmonary embolism. Echocardiography. 2017;34:257–63. Liang HW, Zhao DL, Liu XD, Chen P, Zhou HT, Zhao CL, et al. ECG-gated pulmonary artery CTA for evaluation of right ventricular function in patients with acute pulmonary embolism. Echocardiography. 2017;34:257–63.

go back to reference Coursey C, Nelson R, Boll D, Paulson E, Ho L, Neville A, et al. Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging? RadioGraphics. 2010;30:1037–55.CrossRefPubMed Coursey C, Nelson R, Boll D, Paulson E, Ho L, Neville A, et al. Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging? RadioGraphics. 2010;30:1037–55.CrossRefPubMed

go back to reference Henzler T, Fink C, Schoenberg S, Schoepf U. Dual-energy CT: radiation dose aspects. AJR. 2012;199:S16–25.CrossRefPubMed Henzler T, Fink C, Schoenberg S, Schoepf U. Dual-energy CT: radiation dose aspects. AJR. 2012;199:S16–25.CrossRefPubMed

go back to reference • Petritsch B, Kosmala A, Gassenmaier T, Weng A, Veldhoen S, Kunz A, et al. Diagnosis of pulmonary artery embolism: comparison of single-source CT and 3rd generation dual-source CT using a dual-energy protocol regarding image quality and radiation dose. Fortschr Röntgenstr. 2017;189:527–36. This study demonstrated the ability of new generation dual-source scanners to decrease the radiation dose significantly to patients while providing excellent image quality when compared to older scanners.CrossRef • Petritsch B, Kosmala A, Gassenmaier T, Weng A, Veldhoen S, Kunz A, et al. Diagnosis of pulmonary artery embolism: comparison of single-source CT and 3rd generation dual-source CT using a dual-energy protocol regarding image quality and radiation dose. Fortschr Röntgenstr. 2017;189:527–36. This study demonstrated the ability of new generation dual-source scanners to decrease the radiation dose significantly to patients while providing excellent image quality when compared to older scanners.CrossRef

go back to reference Ohana M, Labani A, Jeung MY, SEl G, Gaertner S, Roy C. Iterative reconstruction in single source dual-energy CT pulmonary angiography: is it sufficient to achieve a radiation dose as low as state-of-the-art single-energy CTPA? Eur J Radiol. 2015;84:2314–20.CrossRefPubMed Ohana M, Labani A, Jeung MY, SEl G, Gaertner S, Roy C. Iterative reconstruction in single source dual-energy CT pulmonary angiography: is it sufficient to achieve a radiation dose as low as state-of-the-art single-energy CTPA? Eur J Radiol. 2015;84:2314–20.CrossRefPubMed

go back to reference Bae K, Jeon KN, Cho SB, Park SE, Moon JI, Baek HJ, et al. Improved opacification of a suboptimally enhanced pulmonary artery in chest CT: experience using a dual-layer detector spectral CT. AJR. 2018;210:734–41. Bae K, Jeon KN, Cho SB, Park SE, Moon JI, Baek HJ, et al. Improved opacification of a suboptimally enhanced pulmonary artery in chest CT: experience using a dual-layer detector spectral CT. AJR. 2018;210:734–41.

go back to reference • Kong WF, Wang YT, Yin LL, Pu H, Tao KY. Clinical risk stratification of acute pulmonary embolism: comparing the usefulness of CTA obstruction score and pulmonary perfusion defect score with dual-energy CT. Int J Cardiovasc Imaging. 2017;33:2039–47. This study demonstrates the clinical value of perfusion maps for clinical risk stratification, demonstrating good correlation of perfusion maps to right ventricular dysfunction, thus providing additional information beyond simple anatomic characterization, highlighting the added value of dual-energy CT.CrossRefPubMed • Kong WF, Wang YT, Yin LL, Pu H, Tao KY. Clinical risk stratification of acute pulmonary embolism: comparing the usefulness of CTA obstruction score and pulmonary perfusion defect score with dual-energy CT. Int J Cardiovasc Imaging. 2017;33:2039–47. This study demonstrates the clinical value of perfusion maps for clinical risk stratification, demonstrating good correlation of perfusion maps to right ventricular dysfunction, thus providing additional information beyond simple anatomic characterization, highlighting the added value of dual-energy CT.CrossRefPubMed

go back to reference Takx R, Henzler T, Schoepf J, Germann T, Schoenberg S, Shirinova A, et al. Predictive value of perfusion defects on dual energy CTA in the absence of thromboembolic clots. J Cardiovasc Comput Tomogr. 2017;11:183–7.CrossRefPubMed Takx R, Henzler T, Schoepf J, Germann T, Schoenberg S, Shirinova A, et al. Predictive value of perfusion defects on dual energy CTA in the absence of thromboembolic clots. J Cardiovasc Comput Tomogr. 2017;11:183–7.CrossRefPubMed

go back to reference Guberina N, Lechel U, Forsting M, Ringelstein A. Efficacy of high-pitch CT protocols for radiation dose reduction. J Radiol Prot. 2016;36:N57–66.CrossRefPubMed Guberina N, Lechel U, Forsting M, Ringelstein A. Efficacy of high-pitch CT protocols for radiation dose reduction. J Radiol Prot. 2016;36:N57–66.CrossRefPubMed

go back to reference DU Q, Sui X, Song L, Xu X. Application of high pitch CT pulmonary angiography at 70 kV tube voltage with 15 ml contrast medium using third-generation dual-source CT. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017;39(1):28–33.PubMed DU Q, Sui X, Song L, Xu X. Application of high pitch CT pulmonary angiography at 70 kV tube voltage with 15 ml contrast medium using third-generation dual-source CT. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017;39(1):28–33.PubMed

go back to reference Van Ginneken B. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning. Radiol Phys Technol. 2017;10:23–32.CrossRefPubMedPubMedCentral Van Ginneken B. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning. Radiol Phys Technol. 2017;10:23–32.CrossRefPubMedPubMedCentral

go back to reference Blackmon K, Florin C, Bogoni L, McCain J, Koonce J, Lee H, et al. Computer-aided detection of pulmonary embolism at CT pulmonary angiography: can it improve performance of inexperienced readers? Eur Radiol. 2011;21:1214–23.CrossRefPubMed Blackmon K, Florin C, Bogoni L, McCain J, Koonce J, Lee H, et al. Computer-aided detection of pulmonary embolism at CT pulmonary angiography: can it improve performance of inexperienced readers? Eur Radiol. 2011;21:1214–23.CrossRefPubMed

go back to reference Wittenberg R, Berger F, Peters J, Weber M, Van Hoorn F, Beenen L, et al. Acute pulmonary embolism: effect of a computer-assisted detection prototype on diagnosis—an observer study. Radiology. 2012;262:305–13.CrossRefPubMed Wittenberg R, Berger F, Peters J, Weber M, Van Hoorn F, Beenen L, et al. Acute pulmonary embolism: effect of a computer-assisted detection prototype on diagnosis—an observer study. Radiology. 2012;262:305–13.CrossRefPubMed

go back to reference Wittenberg R, Peters J, Van Den Berk I, Freling N, Lely R, Hoop B, et al. Computed tomography pulmonary angiography in acute pulmonary embolism. The effect of a computer-assisted detection prototype used as a concurrent reader. J Thorac Imaging. 2013;28:315–21.CrossRefPubMed Wittenberg R, Peters J, Van Den Berk I, Freling N, Lely R, Hoop B, et al. Computed tomography pulmonary angiography in acute pulmonary embolism. The effect of a computer-assisted detection prototype used as a concurrent reader. J Thorac Imaging. 2013;28:315–21.CrossRefPubMed

go back to reference American College of Radiology ACR Appropriateness Criteria for Suspected Pulmonary Embolism. Revised in 2016-acsearch.acr.org/docs/69404/Narrative/. American College of Radiology ACR Appropriateness Criteria for Suspected Pulmonary Embolism. Revised in 2016-acsearch.acr.​org/​docs/​69404/​Narrative/.

go back to reference Stein P, Chenevert T, Fowler S, Goodman L, Gottschalk A, Hales C, et al. Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III). Ann Intern Med. 2010;152(7):434–W143. Stein P, Chenevert T, Fowler S, Goodman L, Gottschalk A, Hales C, et al. Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III). Ann Intern Med. 2010;152(7):434–W143.

go back to reference Squizzato A, Pomero R, Allione A, Priotto R, Riva N, Huisman M, et al. Diagnostic accuracy of magnetic resonance imaging in patients with suspected pulmonary embolism: a bivariate meta-analysis. Thromb Res. 2017;154:64–72.CrossRefPubMed Squizzato A, Pomero R, Allione A, Priotto R, Riva N, Huisman M, et al. Diagnostic accuracy of magnetic resonance imaging in patients with suspected pulmonary embolism: a bivariate meta-analysis. Thromb Res. 2017;154:64–72.CrossRefPubMed

go back to reference Nyrén S, Nordgren Rogberg A, Paris R, Bengtsson B, Westerlund E, Lindholm P. Detection of pulmonary embolism using repeated MRI acquisitions without respiratory gating: a preliminary study. Acta Radiol. 2017;58(3):272–8.CrossRefPubMed Nyrén S, Nordgren Rogberg A, Paris R, Bengtsson B, Westerlund E, Lindholm P. Detection of pulmonary embolism using repeated MRI acquisitions without respiratory gating: a preliminary study. Acta Radiol. 2017;58(3):272–8.CrossRefPubMed

go back to reference Nagle S, Schiebler M, Repplinger M, François CJ, Vigen KK, Yarlagadda R, et al. Contrast enhanced pulmonary magnetic resonance angiography for pulmonary embolism: building a successful program. Eur J Radiol. 2016;85:553–63.CrossRefPubMed Nagle S, Schiebler M, Repplinger M, François CJ, Vigen KK, Yarlagadda R, et al. Contrast enhanced pulmonary magnetic resonance angiography for pulmonary embolism: building a successful program. Eur J Radiol. 2016;85:553–63.CrossRefPubMed

go back to reference Chen F, Shen YH, Zhu XQ, Zheng J, Wu FJ, et al. Comparison between CT and MRI in the assessment of pulmonary embolism. Medicine. 2017;96:52. Chen F, Shen YH, Zhu XQ, Zheng J, Wu FJ, et al. Comparison between CT and MRI in the assessment of pulmonary embolism. Medicine. 2017;96:52.

go back to reference •• Repplinger M, Nagle S, Harringa J, Broman AT, Lindholm CR, François CJ, et al. Clinical outcomes after magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) for pulmonary embolism evaluation. Emergency Radiology, published on line: 2018. This study demonstrated better long-term outcomes with fewer adverse PE-related events in patients that underwent MRA vs those that underwent CTA with nearly identical technical success rates for both modalities, thus showing the great potential of MRA for widespread routine use in PE imaging. •• Repplinger M, Nagle S, Harringa J, Broman AT, Lindholm CR, François CJ, et al. Clinical outcomes after magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) for pulmonary embolism evaluation. Emergency Radiology, published on line: 2018. This study demonstrated better long-term outcomes with fewer adverse PE-related events in patients that underwent MRA vs those that underwent CTA with nearly identical technical success rates for both modalities, thus showing the great potential of MRA for widespread routine use in PE imaging.

go back to reference • Pasin L, Zanon M, Moreira J, Moreira AL, Watte G, Marchiori E, et al. Magnetic resonance imaging of pulmonary embolism: diagnostic accuracy of unenhanced MR and influence in mortality rates. Lung. 2017;195:193–9. This study demonstrates the excellent detection capabilities of unenhanced MRA for suspected PE, making this technique especially useful for a subset of patients that cannot receive intravenous contrast.CrossRefPubMed • Pasin L, Zanon M, Moreira J, Moreira AL, Watte G, Marchiori E, et al. Magnetic resonance imaging of pulmonary embolism: diagnostic accuracy of unenhanced MR and influence in mortality rates. Lung. 2017;195:193–9. This study demonstrates the excellent detection capabilities of unenhanced MRA for suspected PE, making this technique especially useful for a subset of patients that cannot receive intravenous contrast.CrossRefPubMed

go back to reference Schwenk M. Ferumoxytol: a new intravenous Iron preparation for the treatment of Iron deficiency anemia in patients with chronic kidney disease. Pharmacotherapy. 2010;30(1):70–9.CrossRefPubMed Schwenk M. Ferumoxytol: a new intravenous Iron preparation for the treatment of Iron deficiency anemia in patients with chronic kidney disease. Pharmacotherapy. 2010;30(1):70–9.CrossRefPubMed

go back to reference Bashir MR, Jaffe TA, Brennan TV, Patel UD, Ellis MJ, et al. Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent. Transplantation. 2013;96:91–6. Bashir MR, Jaffe TA, Brennan TV, Patel UD, Ellis MJ, et al. Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent. Transplantation. 2013;96:91–6.

go back to reference Nayak AB, Luhar A, Hanudel M, Gales B, Hall TR, Finn JP, et al. High-resolution, whole-body vascular imaging with ferumoxytol as an alternative to gadolinium agents in a pediatric chronic kidney disease cohort. Pediatr Nephrol. 2015;30(3):515–21. Nayak AB, Luhar A, Hanudel M, Gales B, Hall TR, Finn JP, et al. High-resolution, whole-body vascular imaging with ferumoxytol as an alternative to gadolinium agents in a pediatric chronic kidney disease cohort. Pediatr Nephrol. 2015;30(3):515–21.

go back to reference Nguyen KL, Moriarty JM, Plotnik AN, Aksoy O, Yoshida T, Shemin RJ, et al. Ferumoxytol-enhanced MR angiography for vascular access mapping before transcatheter aortic valve replacement in patients with renal impairment: a step toward patient-specific care. Radiology. 2018;286(1):326–37. Nguyen KL, Moriarty JM, Plotnik AN, Aksoy O, Yoshida T, Shemin RJ, et al. Ferumoxytol-enhanced MR angiography for vascular access mapping before transcatheter aortic valve replacement in patients with renal impairment: a step toward patient-specific care. Radiology. 2018;286(1):326–37.

go back to reference Chin MS, Steigner M, Yin W, Kwong RY, Siedlecki AM, et al. Intraluminal assessment of coronary arteries with ferumoxytol-enhanced magnetic resonance angiography. JACC Cardiovasc Imaging. 2018;11(3):505–8.CrossRefPubMed Chin MS, Steigner M, Yin W, Kwong RY, Siedlecki AM, et al. Intraluminal assessment of coronary arteries with ferumoxytol-enhanced magnetic resonance angiography. JACC Cardiovasc Imaging. 2018;11(3):505–8.CrossRefPubMed

go back to reference Leung AN, Bull TM, Jaeschke R, Lockwood CJ, Boiselle PM, Hurwitz LM, et al. American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline—evaluation of suspected pulmonary embolism in pregnancy. Radiology. 2012;262:635–46. Leung AN, Bull TM, Jaeschke R, Lockwood CJ, Boiselle PM, Hurwitz LM, et al. American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline—evaluation of suspected pulmonary embolism in pregnancy. Radiology. 2012;262:635–46.

go back to reference Sierra-Galan LM, García-Buen-Abad RG, Sauza-Sosa JS. Unenhanced CMR for suspected pulmonary embolism during the first trimester of pregnancy. When avoiding ionizating radiation and dose really matters. Case report 15-17, Society of Cardiovascular Magnetic Resonance. Sierra-Galan LM, García-Buen-Abad RG, Sauza-Sosa JS. Unenhanced CMR for suspected pulmonary embolism during the first trimester of pregnancy. When avoiding ionizating radiation and dose really matters. Case report 15-17, Society of Cardiovascular Magnetic Resonance.

go back to reference Heredia V, Altun H, Ramalho M, de Campos R, Azevedo R, Pamuklar E, et al. MRI of pregnant patients for suspected pulmonary embolism: steady-state free precession vs postgadolinium 3D-GRE. Acta Medica Port. 2012;25(6):359–67. Heredia V, Altun H, Ramalho M, de Campos R, Azevedo R, Pamuklar E, et al. MRI of pregnant patients for suspected pulmonary embolism: steady-state free precession vs postgadolinium 3D-GRE. Acta Medica Port. 2012;25(6):359–67.

go back to reference Lang IM, Madani M. Update on chronic thromboembolic pulmonary hypertension. Circulation. 2014;130:508–18.CrossRefPubMed Lang IM, Madani M. Update on chronic thromboembolic pulmonary hypertension. Circulation. 2014;130:508–18.CrossRefPubMed

go back to reference Gopalan D, Delcroix M, Held M. Diagnosis of chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2017;26:160108.CrossRefPubMed Gopalan D, Delcroix M, Held M. Diagnosis of chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2017;26:160108.CrossRefPubMed

go back to reference Johns CS, Swift AJ, Rajaram S, Hughes PJC, Capener DJ, Kiely DG, et al. Lung perfusion: MRI vs. SPECT for screening in suspected chronic thromboembolic pulmonary hypertension. J Magn Reson Imaging. 2017;46:1693–7. Johns CS, Swift AJ, Rajaram S, Hughes PJC, Capener DJ, Kiely DG, et al. Lung perfusion: MRI vs. SPECT for screening in suspected chronic thromboembolic pulmonary hypertension. J Magn Reson Imaging. 2017;46:1693–7.

go back to reference Rajaram S, Swift AJ, Telfer A, Hurdman J, Marshall H, Lorenz E, et al. 3D contrast-enhanced lung perfusion MRI is an effective screening tool for chronic thromboembolic pulmonary hypertension: results from the ASPIRE Registry. Thorax. 2013;68(7):677–8. Rajaram S, Swift AJ, Telfer A, Hurdman J, Marshall H, Lorenz E, et al. 3D contrast-enhanced lung perfusion MRI is an effective screening tool for chronic thromboembolic pulmonary hypertension: results from the ASPIRE Registry. Thorax. 2013;68(7):677–8.

go back to reference • Andia ME, Saha P, Jenkins J, Modarai B, Wiethoff AJ, Phinikaridou A, et al. Fibrin-targeted magnetic resonance imaging allows in vivo quantification of thrombus fibrin content and identifies thrombi amenable for thrombolysis. Arterioscler Thromb Vasc Biol. 2014;34:1193–8. This study demonstrates the future applications of molecular MRI imaging, potentially allowing targeted contrast agents that identify and accurately quantify thrombus burden. • Andia ME, Saha P, Jenkins J, Modarai B, Wiethoff AJ, Phinikaridou A, et al. Fibrin-targeted magnetic resonance imaging allows in vivo quantification of thrombus fibrin content and identifies thrombi amenable for thrombolysis. Arterioscler Thromb Vasc Biol. 2014;34:1193–8. This study demonstrates the future applications of molecular MRI imaging, potentially allowing targeted contrast agents that identify and accurately quantify thrombus burden.

go back to reference Vymazal J, Spuentrup E, Gerardo Cardenas-Molina G, Wiethoff AJ, Hartmann MG, Caravan P, et al. Thrombus imaging with fibrin-specific gadolinium-based MR contrast agent EP-2104R, results of a phase II clinical study of feasibility. Investig Radiol. 2009;44:697–704.CrossRef Vymazal J, Spuentrup E, Gerardo Cardenas-Molina G, Wiethoff AJ, Hartmann MG, Caravan P, et al. Thrombus imaging with fibrin-specific gadolinium-based MR contrast agent EP-2104R, results of a phase II clinical study of feasibility. Investig Radiol. 2009;44:697–704.CrossRef

go back to reference McCarthy J, Patel P, Botnaru I, Haghayeghi P, Weissleder R, Jaffer FA, et al. Multimodal nanoagents for the detection of intravascular thrombi. Bioconjug Chem. 2009;20:1251–5.CrossRefPubMedPubMedCentral McCarthy J, Patel P, Botnaru I, Haghayeghi P, Weissleder R, Jaffer FA, et al. Multimodal nanoagents for the detection of intravascular thrombi. Bioconjug Chem. 2009;20:1251–5.CrossRefPubMedPubMedCentral

go back to reference Heidt T, Ehrismann S, Hövener JB, Neudorfer I, Hilgendorf I, Reisert M, et al. Molecular imaging of activated platelets allows the detection of pulmonary embolism with magnetic resonance imaging. Sci Rep. 2016;6:25044. 1–9 Heidt T, Ehrismann S, Hövener JB, Neudorfer I, Hilgendorf I, Reisert M, et al. Molecular imaging of activated platelets allows the detection of pulmonary embolism with magnetic resonance imaging. Sci Rep. 2016;6:25044. 1–9

go back to reference The PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA. 1990;263:2753–9.CrossRef The PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA. 1990;263:2753–9.CrossRef

go back to reference •• Phillips JJ, Straiton J, Staff RT. Planar and SPECT ventilation/perfusion imaging and computed tomography for the diagnosis of pulmonary embolism: a systematic review and meta-analysis of the literature, and cost and dose comparison. Eur J Radiol. 2015;84:1392–400. This large meta-analysis demonstrated the diagnostic superiority of SPECT V/Q compared to planar V/Q while having the smallest radiation burden compared to both CTPA and planar V/Q.CrossRefPubMed •• Phillips JJ, Straiton J, Staff RT. Planar and SPECT ventilation/perfusion imaging and computed tomography for the diagnosis of pulmonary embolism: a systematic review and meta-analysis of the literature, and cost and dose comparison. Eur J Radiol. 2015;84:1392–400. This large meta-analysis demonstrated the diagnostic superiority of SPECT V/Q compared to planar V/Q while having the smallest radiation burden compared to both CTPA and planar V/Q.CrossRefPubMed

go back to reference Isidoro J, Gil P, Costa G, Pedroso de Lima J, Alves C, Ferreira NC. Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. Physica Medica. 2017;41:93–6.CrossRefPubMed Isidoro J, Gil P, Costa G, Pedroso de Lima J, Alves C, Ferreira NC. Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. Physica Medica. 2017;41:93–6.CrossRefPubMed

go back to reference Bajc M, Neilly JB, Miniati M, Schuemichen C, Meignan M, Jonson B. EANM guidelines for ventilation/perfusion scintigraphy. Eur J Nucl Med Mol Imaging. 2009;36:1356–70.CrossRefPubMed Bajc M, Neilly JB, Miniati M, Schuemichen C, Meignan M, Jonson B. EANM guidelines for ventilation/perfusion scintigraphy. Eur J Nucl Med Mol Imaging. 2009;36:1356–70.CrossRefPubMed

go back to reference Le Roux PY, Pelletier-Galarneau M, De Laroche R, Hofman MS, Zuckier LS, Roach P, et al. Pulmonary scintigraphy for the diagnosis of acute pulmonary embolism: a survey of current practices in Australia, Canada, and France. J Nucl Med. 2015;56:1212–7.CrossRefPubMed Le Roux PY, Pelletier-Galarneau M, De Laroche R, Hofman MS, Zuckier LS, Roach P, et al. Pulmonary scintigraphy for the diagnosis of acute pulmonary embolism: a survey of current practices in Australia, Canada, and France. J Nucl Med. 2015;56:1212–7.CrossRefPubMed

go back to reference Le Roux PY, Robin P, Tromeur C, Davis A, Robert-Ebadi H, Carrier M, et al. SPECT V/Q for the diagnosis of pulmonary embolism: protocol for a systematic review and meta-analysis of diagnostic accuracy and clinical outcome. BMJ Open. 2018;8:e022024.CrossRefPubMedPubMedCentral Le Roux PY, Robin P, Tromeur C, Davis A, Robert-Ebadi H, Carrier M, et al. SPECT V/Q for the diagnosis of pulmonary embolism: protocol for a systematic review and meta-analysis of diagnostic accuracy and clinical outcome. BMJ Open. 2018;8:e022024.CrossRefPubMedPubMedCentral

go back to reference Le Roux PY, Robin P, Delluc A, Abgral R, Palard X, Tissot V, et al. Additional value of combining low-dose computed tomography to V/Q SPECT on a hybrid SPECT-CT camera for pulmonary embolism diagnosis. Nucl Med Commun. 2015;36:922–30.CrossRefPubMed Le Roux PY, Robin P, Delluc A, Abgral R, Palard X, Tissot V, et al. Additional value of combining low-dose computed tomography to V/Q SPECT on a hybrid SPECT-CT camera for pulmonary embolism diagnosis. Nucl Med Commun. 2015;36:922–30.CrossRefPubMed

go back to reference Jögi J, Markstad H, Tufvesson E, Bjermer L, Bajc M. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used. Int J COPD. 2015;10:25–30. Jögi J, Markstad H, Tufvesson E, Bjermer L, Bajc M. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used. Int J COPD. 2015;10:25–30.

go back to reference Mortensen J, Gutte H. SPECT/CT and pulmonary embolism. Eur J Nucl Med Mol Imaging. 2014;41(Suppl 1):S81–90.CrossRefPubMed Mortensen J, Gutte H. SPECT/CT and pulmonary embolism. Eur J Nucl Med Mol Imaging. 2014;41(Suppl 1):S81–90.CrossRefPubMed

go back to reference Gutte H, Mortensen J, Jensen CV, Johnbeck CB, von der Recke P, Petersen CL, et al. Detection of pulmonary embolism with combined ventilation–perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography. J Nucl Med. 2009;50:1987–92. Gutte H, Mortensen J, Jensen CV, Johnbeck CB, von der Recke P, Petersen CL, et al. Detection of pulmonary embolism with combined ventilation–perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography. J Nucl Med. 2009;50:1987–92.

go back to reference Toney LK, Kim RD, Palli SR. The economic value of hybrid single-photon emission computed tomography with computed tomography imaging in pulmonary embolism diagnosis. Acad Emerg Med. 2017;24:1110–23.CrossRefPubMedPubMedCentral Toney LK, Kim RD, Palli SR. The economic value of hybrid single-photon emission computed tomography with computed tomography imaging in pulmonary embolism diagnosis. Acad Emerg Med. 2017;24:1110–23.CrossRefPubMedPubMedCentral

go back to reference Bailey DL, Eslick EM, Schembri GP, Roach PJ. 68Ga PET ventilation and perfusion lung imaging—current status and future challenges. Semin Nucl Med. 2016;46:428–35.CrossRefPubMed Bailey DL, Eslick EM, Schembri GP, Roach PJ. 68Ga PET ventilation and perfusion lung imaging—current status and future challenges. Semin Nucl Med. 2016;46:428–35.CrossRefPubMed

go back to reference Hofman MS, Beauregard JM, Barber TW, Neels OC, Eu P, Hicks RJ. 68Ga PET/CT ventilation–perfusion imaging for pulmonary embolism: a pilot study with comparison to conventional scintigraphy. J Nucl Med. 2011;52:1513–9.CrossRefPubMed Hofman MS, Beauregard JM, Barber TW, Neels OC, Eu P, Hicks RJ. 68Ga PET/CT ventilation–perfusion imaging for pulmonary embolism: a pilot study with comparison to conventional scintigraphy. J Nucl Med. 2011;52:1513–9.CrossRefPubMed

go back to reference Le Roux PY, Robin P, Delluc A, Tardy B, Abgral R, Couturaud F, et al. Performance of 18F fluoro-2-désoxy-D-glucose positron emission tomography/computed tomography for the diagnosis of venous thromboembolism. Thromb Res. 2015;135:31–5.CrossRefPubMed Le Roux PY, Robin P, Delluc A, Tardy B, Abgral R, Couturaud F, et al. Performance of 18F fluoro-2-désoxy-D-glucose positron emission tomography/computed tomography for the diagnosis of venous thromboembolism. Thromb Res. 2015;135:31–5.CrossRefPubMed

go back to reference Houshmand S, Salavati A, Hess S, Ravina M, Alavi A. The role of molecular imaging in diagnosis of deep vein thrombosis. Am J Nucl Med Mol Imaging. 2014;4(5):406–25.PubMedPubMedCentral Houshmand S, Salavati A, Hess S, Ravina M, Alavi A. The role of molecular imaging in diagnosis of deep vein thrombosis. Am J Nucl Med Mol Imaging. 2014;4(5):406–25.PubMedPubMedCentral

go back to reference Dunzinger A, Hafner F, Schaffler G, Piswanger-Soelkner JC, Brodmann M, Lipp RW. 99mTc-apcitide scintigraphy in patients with clinically suspected deep venous thrombosis and pulmonary embolism. Eur J Nucl Med Mol Imaging. 2008;35:2082–7.CrossRefPubMed Dunzinger A, Hafner F, Schaffler G, Piswanger-Soelkner JC, Brodmann M, Lipp RW. 99mTc-apcitide scintigraphy in patients with clinically suspected deep venous thrombosis and pulmonary embolism. Eur J Nucl Med Mol Imaging. 2008;35:2082–7.CrossRefPubMed

go back to reference Taillefer R, Edell S, Innes G, Lister-James J. Acute thromboscintigraphy with (99m) Tc-apcitide: results of the phase 3 multicenter clinical trial comparing 99mTc-apcitide scintigraphy with contrast venography for imaging acute DVT. Multicenter Trial Investigators. J Nucl Med. 2000;41:1214–23.PubMed Taillefer R, Edell S, Innes G, Lister-James J. Acute thromboscintigraphy with (99m) Tc-apcitide: results of the phase 3 multicenter clinical trial comparing 99mTc-apcitide scintigraphy with contrast venography for imaging acute DVT. Multicenter Trial Investigators. J Nucl Med. 2000;41:1214–23.PubMed

go back to reference Morris TA, Gerometta M, Yusen RD, White RH, Douketis JD, Kaatz S, et al. Detection of pulmonary emboli with 99m Tc-labeled anti-D-dimer (DI-80B3) Fab9 fragments (ThromboView). Am J Respir Crit Care Med. 2011;184:708–14.CrossRefPubMed Morris TA, Gerometta M, Yusen RD, White RH, Douketis JD, Kaatz S, et al. Detection of pulmonary emboli with 99m Tc-labeled anti-D-dimer (DI-80B3) Fab9 fragments (ThromboView). Am J Respir Crit Care Med. 2011;184:708–14.CrossRefPubMed

go back to reference Douketis JD, Ginsberg JS, Haley S, Julian J, Dwyer M, Levine M, et al. Accuracy and safety of (99m) Tc-labeled anti-D-dimer (DI-80B3) Fab′ fragments (ThromboView(R)) in the diagnosis of deep vein thrombosis: a phase II study. Thromb Res. 2012;130(3):381–9. Douketis JD, Ginsberg JS, Haley S, Julian J, Dwyer M, Levine M, et al. Accuracy and safety of (99m) Tc-labeled anti-D-dimer (DI-80B3) Fab′ fragments (ThromboView(R)) in the diagnosis of deep vein thrombosis: a phase II study. Thromb Res. 2012;130(3):381–9.