Lung scintigraphy is non-diagnostic in most patients suspected of pulmonary embolism when performed in planar mode. Tomographic mode could improve lung scan performance but has not been rigorously assessed. In this study we assessed the usefulness of tomographic mode in patients with a non-diagnostic lung scan scintigraphy.
pulmonary embolism was diagnosed or ruled out in consecutive patients with a non-diagnostic lung scan by the combination of a 4-slices computerized tomography and a lower-limb ultrasonography. Results given by reading the tomographic mode in ventilation/perfusion lung scan were compared to final diagnosis.
142 out of 392 consecutive patients with a non-diagnostic planar lung scintigraphy were included while 47 were excluded, 45 because of contra-indication to contrast medium and 2 because of non-optimal opacification of pulmonary arteries. Ninety-five patients were evaluated. Pulmonary embolism was diagnosed in 20 (21%) patients and ruled out in 75 (79%). Concordance with final diagnosis was found in 77/94 (82%) patients. Tomographic mode was non-diagnostic in 1 (1%) patient. Tomographic mode sensitivity/specificity/accuracy were 0.79/0.83/0.80 respectively. Negative predictive value was 0.94. Discordances were related to single sub segmental or non-occluding segmental thrombus.
Tomographic mode is diagnostic in nearly all patients and agreement with final diagnosis is found in the majority. Its excellent negative predictive value enables to rule out pulmonary embolism. Discordances were related to single sub segmental or non-occluding segmental thrombus which prognosis value remains to be established.
"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."
"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."
"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."
"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."
"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."
"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."
"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."
"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."
"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."
"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."
"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."
"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."
"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."
"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."
"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."
"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."
"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."
"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."
"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."
"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."