Enhanced lung scan diagnosis of pulmonary embolism with the use of ancillary scintigraphic findings and clinical correlation

Analysis of the Prospective Investigation of Pulmonary Embolism Diagnosis ( PIOPED) and modified PIOPED studies has suggested that an experienced obser ver is capable of more accurate lung scan interpretation than the less expe rienced individual. This has been attributed to the use of unique Gestalt f actors not contained in published diagnostic algorithms, which are acquired through extensive experience in reviewing and interpreting lung scans. How fully these factors can he codified and transmitted to less experienced ob servers is uncertain; however, there is a large body of published data that attempts to convey fine points of lung scan interpretation, including a la rge body of ancillary scintigraphic findings and a number of refinements in the application of diagnostic algorithms. Review of these factors will acc elerate the training of less experienced readers. Finally, an understanding of lung scan language and an appreciation of clinically relevant factors, particularly pretest probability, will maximize the reader's ability to use the lung scan in managing patients who are suspected of having pulmonary e mbolic disease. Copyright (C) 2001 by W.B. Saunders Company.