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Proper Interpretation of Radioisotope Lung Scans

Joseph A. Orzel, MD
JAMA. 1985;253(1):40. doi:10.1001/jama.1985.03350250048012.
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To the Editor.—  The recent article by Goffman et al1 was a valuable addition to the literature because it emphasized that perihilar and mediastinal adenopathy can cause significant pulmonary perfusion defects, with relative preservation of ventilation, producing a radionuclide ventilation-perfusion study that could be confused with pulmonary embolic disease. I share their concern that the overdiagnosis of pulmonary emboli may be a common occurrence, perhaps most inappropriately made in young women using oral contraceptives2; however, I am concerned that their experience might discourage the use of radionuclide imaging in evaluating pulmonary embolic disease. The radionuclide study in their patient provided much valuable information, and the diagnostic confusion and inappropriate anticoagulant therapy resulted from improper interpretation of the radionuclide data, not from inherent weakness of this technique.In our imaging department, the radionuclide ventilation perfusion study of their patient would have been performed after careful review of the chest


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