Acute pulmonary thromboembolism: comparison of the diagnostic capabilities of conventional film-screen and digital angiography.

STUDY OBJECTIVE To compare digital to conventional film-screen pulmonary angiography for the diagnosis of acute pulmonary embolism (PE) in a clinical population. DESIGN Retrospective review of patient data, ventilation/perfusion (V/Q) lung scintigraphy reports, and pulmonary angiographic reports. SETTING University hospital, division of interventional radiology. PATIENTS AND METHODS Patient data from 307 film-screen and 266 digital angiograms were analyzed for demographics, V/Q lung scintigraphy findings, and pulmonary artery pressures to define patient populations. The interpretations of film-screen pulmonary angiography were then compared with digital angiography interpretations for the entire group of interventional radiologists as well as the two interventionists who practiced throughout the study interval to determine any difference in rates of diagnosis of acute PE between the two techniques. RESULTS There was no significant difference between the patient populations studied by film-screen or digital techniques for the data reviewed. Digital angiography utilized significantly more contrast material (digital, 173 mL; film-screen, 145 mL; p < 0.01) and a greater number of angiographic views (digital, 3.6 views per patient; film-screen, 3.4 views per patient; p = 0.04) when compared with film-screen angiography. There was no difference between the two techniques in the rates of diagnosis of acute PE, for individual radiologists or overall. CONCLUSIONS Digital and film-screen pulmonary angiography possess equivalent diagnostic capabilities for acute PE as used in a clinical setting.