title: Accuracy of computed tomography angiography in the detection of pulmonary embolism in patients with high body weight.
abstract: BACKGROUND
  The accuracy of CT pulmonary angiography (CTPA) in detecting or excluding pulmonary embolism has not yet been assessed in patients with high body weight (BW).
  
  
  METHODS
  This retrospective study involved CTPAs of 114 patients weighing 75-99 kg and those of 123 consecutive patients weighing 100-150 kg. Three independent blinded radiologists analyzed all examinations in randomized order. Readers' data on pulmonary emboli were compared with a composite reference standard, comprising clinical probability, reference CTPA result, additional imaging when performed and 90-day follow-up. Results in both BW groups and in two body mass index (BMI) groups (BMI <30 kg/m(2) and BMI ≥ 30 kg/m(2), i.e., non-obese and obese patients) were compared.
  
  
  RESULTS
  The prevalence of pulmonary embolism was not significantly different in the BW groups (P=1.0). The reference CTPA result was positive in 23 of 114 patients in the 75-99 kg group and in 25 of 123 patients in the ≥ 100 kg group, respectively (odds ratio, 0.991; 95% confidence interval, 0.501 to 1.957; P=1.0). No pulmonary embolism-related death or venous thromboembolism occurred during follow-up. The mean accuracy of three readers was 91.5% in the 75-99 kg group and 89.9% in the ≥ 100 kg group (odds ratio, 1.207; 95% confidence interval, 0.451 to 3.255; P=0.495), and 89.9% in non-obese patients and 91.2% in obese patients (odds ratio, 0.853; 95% confidence interval, 0.317 to 2.319; P=0.816).
  
  
  CONCLUSIONS
  The diagnostic accuracy of CTPA in patients weighing 75-99 kg or 100-150 kg proved not to be significantly different.
authors.affiliation: Department of Anaesthesiology and Intensive Care, University of Debrecen, Clinical Centre, Nagyerdei krt. 98, Debrecen H-4012, Hungary. Electronic address: megyeri.boglarka@med.unideb.hu.
authors.forename: Boglarka
authors.initials: B
authors.lastname: Megyeri
authors.affiliation: University Institute of Diagnostic, Interventional and Paediatric Radiology, Inselspital, University Hospital Bern, Freiburgstrasse 10, Bern CH-3010, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Christe
authors.affiliation: Department of Radiology, University Hospital Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
authors.forename: Sebastian T
authors.initials: ST
authors.lastname: Schindera
authors.affiliation: Department of Radiology, University of Debrecen, Clinical Centre, Nagyerdei krt. 98, Debrecen H-4012, Hungary.
authors.forename: Edit
authors.initials: E
authors.lastname: Horkay
authors.affiliation: Department of Radiology, University of Debrecen, Clinical Centre, Nagyerdei krt. 98, Debrecen H-4012, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Sikula
authors.affiliation: University Institute of Diagnostic, Interventional and Paediatric Radiology, Inselspital, University Hospital Bern, Freiburgstrasse 10, Bern CH-3010, Switzerland.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Cullmann
authors.affiliation: Department of Radiology, University of Debrecen, Clinical Centre, Nagyerdei krt. 98, Debrecen H-4012, Hungary.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Kollar
authors.affiliation: University Institute of Diagnostic, Interventional and Paediatric Radiology, Inselspital, University Hospital Bern, Freiburgstrasse 10, Bern CH-3010, Switzerland.
authors.forename: Johannes T
authors.initials: JT
authors.lastname: Heverhagen
authors.affiliation: University Institute of Diagnostic, Interventional and Paediatric Radiology, Inselspital, University Hospital Bern, Freiburgstrasse 10, Bern CH-3010, Switzerland; Institute of Radiology, Hospital Centre of Biel, Vogelsang 84, Biel/Bienne CH-2501, Switzerland.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Szucs-Farkas
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: CT angiography; Comparative study; Diagnostic accuracy; Obesity; Pulmonary embolism