Michael Tse-Yin Lu BA, Presenter: Nothing to Disclose

Amanda Whitmore BA, Abstract Co-Author: Nothing to Disclose

Hale Ersoy MD, Abstract Co-Author: Nothing to Disclose

Tianxi Cai PhD, Abstract Co-Author: Nothing to Disclose

Samuel Zachary Goldhaber MD, Abstract Co-Author: Nothing to Disclose

Frank John Rybicki MD, PhD, Abstract Co-Author: Speakers Bureau, Toshiba Corporation, Tokyo, Japan Speakers Bureau, Siemens AG, Malvern, PA Speakers Bureau, Bracco Group, Princeton, NJ

Rene Quiroz MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To determine if the interval increase in RV/LV diameter ratio between a negative prior and positive diagnostic PE CT improves prediction of 30-day mortality compared to the diameter ratio from the positive CT alone.

50 consecutive patients (31 women, mean age = 60 years) with a prior negative PE CT at the CT diagnosis of acute PE (median interval = 63 days) were retrospectively reviewed. For both studies, the reformatted 4 chamber RV/LV diameter ratio (RVd/LVd) was used to define the interval increase, the percent change in RVd/LVd from the negative prior to the positive scan. ROC analysis compared the interval increase versus RVd/LVd from the positive scan alone for accuracy in predicting 30-day all-cause mortality.

For 30-day mortality, an interval increase >15% had sensitivity [0.95CI] = 0.75 [0.49,1.00], specificity = 0.90 [0.80,0.99], PPV = 0.69 [0.44,0.95], and NPV = 0.92 [0.83,1.00]. At a target sensitivity of 0.75, the specificity of the interval increase was significantly higher than that of the RVd/LVd from the positive scan alone (0.90 versus 0.58, p = 0.05). The interval increase (AUC = 0.81) was significantly more accurate (p = 0.05) than the RVd/LVd from the positive scan alone (AUC = 0.66).

The interval increase in 4 chamber RV/LV diameter ratio is superior to the diameter ratio from the positive scan alone for prediction of 30-day mortality.

Interval increase in RV/LV diameter ratio between a negative prior and a positive diagnostic PE CT is an accurate predictor of 30-day mortality and should be reported when a prior study is available.

Lu, M, Whitmore, A, Ersoy, H, Cai, T, Goldhaber, S, Rybicki, F, Quiroz, R, et al, , Prediction of 30-day Mortality after Acute Pulmonary Embolism (PE) Using Interval Increase in RV/LV Diameter Ratio between a Negative Prior and a Positive Diagnostic CT.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4431805.html