title: Advances in the detection of pulmonary embolism.
abstract: BACKGROUND
  Diagnosing or excluding pulmonary embolism is a complex challenge. Many diagnostic instruments can be used in patients with clinically suspected pulmonary embolism nowadays, all with their own (dis-)advantages. Methods/objectives: In this review, these (dis-)advantages are discussed for the following diagnostic instruments: clinical probability assessment, D-dimer concentration, the combination of clinical probability assessment and D-dimer concentration, bilateral compression ultrasonography, ventilation/perfusion scintigraphy, computerized tomographic pulmonary angiography, pulmonary angiography and magnetic resonance pulmonary angiography. A diagnostic strategy, which can be adjusted to local facilities, is provided and discussed.
  
  
  CONCLUSIONS
  Using combinations of some of these diagnostic tools, many diagnostic strategies are possible and every hospital should make its own local protocol suited for the local situation.
authors.affiliation: Erasmus University Medical Center, Department of Hematology, 's Gravendijkwal 230, PO Box 2040, 3000 CA, Rotterdam, The Netherlands +31 10 7033123 ; +31 10 7035814 ; m.kruip@erasmusmc.nl.
authors.forename: Marieke Jha
authors.initials: MJ
authors.lastname: Kruip
authors.forename: Frank Wg
authors.initials: FW
authors.lastname: Leebeek