PMID- 36456459
OWN - NLM
STAT- MEDLINE
DCOM- 20230303
LR  - 20230307
IS  - 1876-7982 (Electronic)
IS  - 1876-7982 (Linking)
VI  - 54
IP  - 1
DP  - 2023 Mar
TI  - Diagnostic test accuracy of imaging modalities for adults with acute pulmonary 
      embolism: A systematic review and meta-analysis.
PG  - 178-194
LID - S1939-8654(22)00601-4 [pii]
LID - 10.1016/j.jmir.2022.11.003 [doi]
AB  - OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the 
      current literature on diagnostic test accuracy (DTA) of imaging modalities for 
      adults with acute pulmonary embolism (APE). BACKGROUND: Medical imaging plays an 
      integral role in evaluating and managing those with APE. Guidance for imaging 
      modality use for APE diagnosis varies due to a lack of clinical standardisation. 
      Despite this, CTPA remains the first-line imaging modality used by clinicians. 
      METHODS: A literature search of PubMed, EMBASE, Trove and Mednar databases 
      (2012-2020; English language) was performed. Studies assessing the DTA of imaging 
      modalities for APE diagnosis were included. DTA studies methodological quality 
      was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 
      (QUADAS-2 tool). Results of eligible studies were pooled using random or fixed 
      effects modelling the calculate the pooled DTA of explored imaging modalities for 
      APE. The Higgins I(2) test were performed to assess between study heterogeneity. 
      RESULTS: 10 Studies, involving 998 participants, were enrolled and pooled using 
      the random effects model. Of the explored modalities, magnetic resonance imaging 
      (MRI), specifically pulmonary MRI and magnetic resonance pulmonary angiography 
      (MRPA) exhibited the highest pooled DTA. Sensitivity, specificity, negative 
      likelihood ratio, positive likelihood ratio and diagnostic odds ratio for MRPA 
      were 0.952 (95% CI, 0.881 to 0.987), 0.857 (95% CI, 0.637 to 0.97), 5.631 (95% 
      CI, 2.163 to 14.659), 0.06 (95% CI, 0.007 to 0.537) and 80.310 (95% CI, 15.607 to 
      413.25) respectively. Based on the QUADAS-2 criteria, most studies presented low 
      to moderate risk of bias and concern regarding applicability. CONCLUSION: The 
      explored ultrasound and MRI protocols which exhibit a lower radiation burden when 
      compared to the current gold standard computed tomography pulmonary angiography 
      (CTPA), have acceptable diagnostic accuracy for APE and can be useful in certain 
      situations.
CI  - Copyright (c) 2022. Published by Elsevier Inc.
FAU - Ransome, William J
AU  - Ransome WJ
AD  - UniSA Allied Health and Human Performance, University of South Australia, 
      Adelaide, Australia.
FAU - Dizon, Janine
AU  - Dizon J
AD  - Aged Care Centre for Growth and Translational Research, College of Nursing and 
      Health Sciences, Flinders University, Adelaide, Australia.
FAU - Guerrero, Katherine
AU  - Guerrero K
AD  - UniSA Allied Health and Human Performance, University of South Australia, 
      Adelaide, Australia.
FAU - Chau, Minh
AU  - Chau M
AD  - Faculty of Health, University of Canberra, Australian Capital Territory, 
      Australia. Electronic address: Shayne.Chau@canberra.edu.au.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20221128
PL  - United States
TA  - J Med Imaging Radiat Sci
JT  - Journal of medical imaging and radiation sciences
JID - 101469694
SB  - IM
MH  - Adult
MH  - Humans
MH  - Animals
MH  - Sensitivity and Specificity
MH  - Magnetic Resonance Imaging
MH  - *Pulmonary Embolism
MH  - Diagnostic Tests, Routine
MH  - *Hominidae
EDAT- 2022/12/02 06:00
MHDA- 2023/03/04 06:00
CRDT- 2022/12/01 22:10
PHST- 2022/07/25 00:00 [received]
PHST- 2022/10/26 00:00 [revised]
PHST- 2022/11/07 00:00 [accepted]
PHST- 2022/12/02 06:00 [pubmed]
PHST- 2023/03/04 06:00 [medline]
PHST- 2022/12/01 22:10 [entrez]
AID - S1939-8654(22)00601-4 [pii]
AID - 10.1016/j.jmir.2022.11.003 [doi]
PST - ppublish
SO  - J Med Imaging Radiat Sci. 2023 Mar;54(1):178-194. doi: 
      10.1016/j.jmir.2022.11.003. Epub 2022 Nov 28.