Nalinda Sashith Panditaratne MBBCh, MRCP, Abstract Co-Author: Nothing to Disclose

Sonal Krishan MD, Presenter: Nothing to Disclose

Rajeev Verma, Abstract Co-Author: Nothing to Disclose

Roderick J. H. Robertson MD, Abstract Co-Author: Nothing to Disclose

There is still no consensus as to whether benefit from addition of CT venography (CTV) to CT pulmonary angiography (CTPA) outweighs the risk of additional radiation dose and cost. The objective of this systematic review and meta-analysis was to assess the incremental role of CTV combined with CTPA in detecting thrombo-embolic disease. The secondary aim was to evaluate whether there is any change in morbidity and mortality in diagnostic algorithms using CTV.

MEDLINE, EMBASE and Web of Science were searched for relevant original articles published from January 1995 to December 2009. Criteria for inclusion of articles were : articles reported in English, spiral or multi-slice scanners were used, CTPA was done with CTV, comparison data on incidence of isolated deep vein thrombosis (DVT) versus pulmonary embolism was available. A random-effects model was used to obtain the incremental value of CTV in detecting thrombo-embolic disease. Morbidity and mortality data was also calculated if available.

24 studies met the inclusion criteria with pooled data resulting in a total number of 17373 patients. Meta-analysis showed CTV increased detection rates by identifying an additional 3% (95% CI 2%,5%) of cases with isolated DVT. The current literature is however lacking in any information on change in morbidity and mortality.

Though addition of CT venography increases detection of thrombo-embolic disease, it is not possible to quantify the current impact on morbidity and mortality from the published data. Future randomized controlled trials and full cost efficacy analyses are recommended.

Addition of indirect CT venography (CTV) to CT pulmonary angiography is becoming common practice and this meta-analysis quantifies the added benefit of CTV in the diagnosis of venous thrombo-embolism.

Panditaratne, N, Krishan, S, Verma, R, Robertson, R, Incremental Value of CT Venography (CTV) Combined with CT Pulmonary Angiography (CTPA) for Detection of Thromboembolic Disease: Systematic Review and Meta Analysis.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001985.html