P178 5 year follow up of patients investigated for suspected pe. what further tests for suspected vte are performed and are they positive

The diagnosis of a Pulmonary Embolism (PE) is a challenging clinical problem, our approach to which has changed greatly since the introduction of Computed tomographic pulmonary angiography (CTPA). CTPA is now established as the imaging modality of choice for the diagnosis of PE, however there are concerns that CTPA causes the over-diagnosis of clinically irrelevant PE,1,2 and there is little data concerning the outcomes and further imaging following a CTPA at long follow-up times. Here we present long term follow-up of CTPAs over 5 years, looking at further imaging related to suspected thromboembolic disease after more than 2000 studies. After their initial CTPA, further studies were documented retrospectively using electronic patient records. Figure 1 demonstrates what further imaging for suspected venous thromboembolic event (VTE) patients had following their CTPAs scans over 5 years. In a one-year period, 24% of the negative studies, 38% of the positive, and 50% of the indeterminate studies had repeat testing for suspected thromboembolic disease. Indeterminate studies received repeat testing faster (p References Wiener RS, Schwartz LM, Woloshin S. Time trends in pulmonary embolism in the United States: Evidence of overdiagnosis. Arch Intern Med. American Medical Association2011;171(9):831–7. Morley NCD, Muir KC, Mirsadraee S, van Beek EJR, Murchison JT. Ten years of imaging for pulmonary embolism: Too many scans or the tip of an iceberg?Clin Radiol: Elsevier2015.