Does the anatomic distribution of acute pulmonary emboli at MDCT pulmonary angiography in oncology-population differ from that in non-oncology counterpart?

Abstract

ObjectiveTo compare the prevalence and the anatomic distribution of acute PE in oncology patients with those of non oncology patients using multidetector CT (MDCT) pulmonary angiography. Material and methodsWe prospectively reviewed 80 consecutive patients having pathologically proven neoplasms and clinically suspected to have acute PE. Similarly, the other group included 80 consecutive age-matched patients with the clinical suspicion of acute PE, nonetheless, with irrelevant oncologic history. All patients underwent MDCT pulmonary angiography. The PE involvement according to pulmonary arterial level was classified. Lobar location was also recorded using standard nomenclature. ResultsTwenty six patients (33%) of the 80 oncology patients compared to 19 patients (24%) of the 80 non oncology group had acute PE at pulmonary MDCT angiographic examinations. Among the oncology patients, acute PE was located in the main pulmonary artery in 7 (13%), the lobar pulmonary artery in 22 (40%), the segmental pulmonary artery in 17 (31%) and the subsegmental pulmonary artery in 9 (16%) patients. Whereas in the non oncology group, the level of involvement of PE was the main pulmonary artery in 4 (10%) patients, the lobar pulmonary artery in 17 (40%), the segmental pulmonary artery in 15 (36%) and the subsegmental pulmonary artery in 6 (14%). Alternatively, there was a lower lobar predominance in both groups. ConclusionThe prevalence of acute PE is more common among oncology patients than previously reported and has a slight predilection to a central distribution.