RT Journal Article
SR Electronic
T1 Does abdominal-pelvic CT detect occult malignancy in patients with unprovoked pulmonary embolism?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1868
DO 10.1183/13993003.congress-2020.1868
VO 56
IS suppl 64
A1 Bana Hawramy
A1 Julian Ting
A1 Dipansu Ghosh
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/1868.abstract
AB Background: Pulmonary embolism(PE) may be the earliest sign of occult cancer resulting in a wide variation in practice as to how to screen for it.ESC guideline recommends careful history taking,physical examination,and basic initial investigations.The NICE guidelines suggest consider abdomino-pelvic CT scan(CT A/P)in all patients aged over 40 years with a first unprovoked PE without signs or symptoms of cancer based on initial investigations.Aim: To assess the yield of CT A/P in unprovoked PE in patient aged over 40 without signs or symptoms suggestive of cancer.Method: We performed a retrospective analysis of all patients who had PE on CT pulmonary angiogram during one year period(Jan2018- Jan2019) in a tertiary teaching hospital.Results: 70%(199/283) had an acute unprovoked PE.13 patients were under the age of 40,hence 186 patients were included.84(45%)patients had CT A/P.Cancer was detected in only 1 out of 33 patients with red flag signs or symptoms and was negative in 51(61%)patients without signs or symptoms of cancer.115 patients including 8 patients with red flags did not have CT A/P.4 out of 8 patients with red flags were referred to other disciplines for targeted investigation.Subsequently one patient was diagnosed with cancer but without needing CT A/P and another patient was diagnosed with cancerous colonic polyp on routine bowel screening.In the remaining 183 patients no cancer was detected during one year follow up period.Conclusion: Our data shows routine CT A/P in patient with unprovoked PE doesn’t increase the rate of cancer detection in patients without signs or symptoms of cancer.The risk of radiation versus benefit is not justified to warrant routine imaging for cancer.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1868.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).