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Diagnostics
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Advances in Pulmonary Embolism Diagnosis
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Advances in Pulmonary Embolism Diagnosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 8603

Special Issue Editor

Prof. Dr. Pierre Marie Roy

E-Mail
Guest Editor
1. Emergency Department & Vascular Medicine Department, University Hospital of Angers, Angers, France
2. Institut MitoVasc, UMR CNRS 6215 INSERM 1083, Health Faculty, University of Angers, Angers, France
Interests: pulmonary embolism; anticoagulant; emergency medicine; venous thromboembolism; diagnosis; clinical practice

Special Issue Information

Dear Colleagues,

Acute pulmonary embolism (PE) is a frequent and severe disease. A lack or a delay of diagnosis and appropriate treatment initiation may be life-threatening.

In recent decades, lots of progress has been made in the diagnosis of PE and the current main strategy, based on the assessment of the pretest clinical probability, D-dimer measurement and computed tomography pulmonary angiography (CTPA), achieves a very low rate of false negative testing. Nevertheless, the diagnosis of PE remains challenging due to several aspects. Indeed, recent observations suggest an over-testing and overdiagnosis of PE with CTPA. Conversely, the diagnosis of PE is still unfrequently evoked and/or difficult to perform in some conditions, as recently highlighted by the COVID-19 pandemic.

This Special Issue would like to report the latest research on the diagnosis of pulmonary embolism, and authors are invited to submit their articles (original research, protocol or review papers) for consideration.

Prof. Dr. Pierre Marie Roy
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pulmonary embolism
  • diagnosis
  • over-testing
  • clinical pretest probability
  • computed tomography pulmonary angiography
  • D-dimer

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Published Papers (3 papers)

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Review

13 pages, 297 KiB  
Review
How to Combat Over-Testing for Patients Suspected of Pulmonary Embolism: A Narrative Review
by Pierre-Marie Roy, Thomas Moumneh, Thomas Bizouard, Damien Duval and Delphine Douillet
Diagnostics 2023, 13(7), 1326; https://doi.org/10.3390/diagnostics13071326 - 3 Apr 2023
Cited by 1 | Viewed by 1774
Abstract
The diagnosis of PE remains difficult in 2023 because the signs and symptoms are not sensible nor specific. The consequences of potential diagnostic errors can be dramatic, whether by default or by excess. Furthermore, the achievement of a simple diagnostic strategy, based on [...] Read more.
The diagnosis of PE remains difficult in 2023 because the signs and symptoms are not sensible nor specific. The consequences of potential diagnostic errors can be dramatic, whether by default or by excess. Furthermore, the achievement of a simple diagnostic strategy, based on clinical probability assessment, D-dimer measurement and computed tomography pulmonary angiography (CTPA) leads to a new challenge for PE diagnosis: over-testing. Indeed, since the 2000s, the wide availability of CTPA resulted in a major increase in investigations with a mod I confirm erate increase in PE diagnosis, without any notable improvement in patient outcomes. Quite the contrary, the complications of anticoagulation for PE increased significantly, and the long-term consequences of imaging diagnostic radiation is an important concern, especially the risk of breast cancer for young women. As a result, several strategies have been proposed to fight over-testing. They are mostly based on defining a subgroup of patients for whom no specific exam should be required to rule-out PE and adjusting the D-dimer cutoff to allow the exclusion of PE without performing CTPA. This narrative review presents the advantages and limitations of these different strategies as well as the perspective in PE diagnosis. Full article
(This article belongs to the Special Issue Advances in Pulmonary Embolism Diagnosis)
10 pages, 577 KiB  
Review
Diagnosis of Pulmonary Embolism during Pregnancy
by Helia Robert-Ebadi, Thomas Moumneh, Grégoire Le Gal and Marc Righini
Diagnostics 2022, 12(8), 1875; https://doi.org/10.3390/diagnostics12081875 - 3 Aug 2022
Cited by 6 | Viewed by 3795
Abstract
Although rare, pulmonary embolism (PE) remains one of the most common causes of severe maternal morbidity and mortality during pregnancy. Among pregnant women with suspected PE, the prevalence of confirmed disease is far lower than in the general population, reflecting the fear of [...] Read more.
Although rare, pulmonary embolism (PE) remains one of the most common causes of severe maternal morbidity and mortality during pregnancy. Among pregnant women with suspected PE, the prevalence of confirmed disease is far lower than in the general population, reflecting the fear of missing the diagnosis and a low threshold to suspect PE in this setting. Two prospective management outcome trials have recently assessed two different diagnostic algorithms based on the assessment of clinical probability, D-dimer, venous compression ultrasonography of the lower limbs (CUS), and computed tomography pulmonary angiography (CTPA). Both demonstrated the safety of such strategies to exclude PE, with a very low failure rate defined as the rate of subsequent 3-month venous thromboembolism in women left untreated after a negative work-up. These studies were also the first to prospectively demonstrate the safety of negative D-dimer associated with a clinical prediction rule to exclude PE without any chest imaging. Pregnant women are known to be a subgroup at particularly high risk of inappropriate diagnostic management, so the implementation of such validated diagnostic strategies in clinical practice should represent a high priority goal. Full article
(This article belongs to the Special Issue Advances in Pulmonary Embolism Diagnosis)
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8 pages, 256 KiB  
Review
Diagnostic Management of Acute Pulmonary Embolism in COVID-19 and Other Special Patient Populations
by Emily S. L. Martens, Menno V. Huisman and Frederikus A. Klok
Diagnostics 2022, 12(6), 1350; https://doi.org/10.3390/diagnostics12061350 - 30 May 2022
Cited by 5 | Viewed by 2175
Abstract
Venous thromboembolism (VTE), in particular acute pulmonary embolism (PE), has been shown to be a frequent and potentially fatal complication of coronavirus disease 2019 (COVID-19). In response to the observed thrombotic complications, a large number of studies has been devoted to the understanding [...] Read more.
Venous thromboembolism (VTE), in particular acute pulmonary embolism (PE), has been shown to be a frequent and potentially fatal complication of coronavirus disease 2019 (COVID-19). In response to the observed thrombotic complications, a large number of studies has been devoted to the understanding and management of COVID-19-associated coagulopathy. Notably, only a limited number of mostly retrospective studies has focused on the optimal diagnostic strategy for suspected PE in COVID-19 patients. As in other special populations, the accuracy of diagnostic algorithms for PE-exclusion has been debated in this specific patient subgroup as the specificity of D-dimer assays and clinical decision rules (CDRs) may be lower than normal. From this viewpoint, we discuss the current state-of-the-art diagnostic algorithms for acute PE with a focus on patients with COVID-19 in the perspective of other special patient populations. Furthermore, we summarize current knowledge regarding the natural history of PE resolution with anticoagulant treatment in patients with COVID-19. Full article
(This article belongs to the Special Issue Advances in Pulmonary Embolism Diagnosis)
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