To the Editor: The clinical update on venous thromboembolism by Lee and colleagues advises that “Ventilation perfusion (V/Q) isotope scanning reliably establishes the diagnosis of PE [pulmonary embolism] if the V/Q features suggest a high probability of PE . . .”.1 Although this is probably true for patients with intermediate or high pretest probability, a discordant result (low pretest probability and high probability V/Q) should be regarded with suspicion.
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- Prince of Wales Hospital, Barker Street, Randwick, NSW 2031.
Correspondence: braggm@sesahs.nsw.gov.au
- 1. Lee CH, Hankey GJ, Ho WK, Eikelboom JW. Venous thromboembolism: diagnosis and management of pulmonary embolism. Med J Aust 2005; 182: 569-574. <MJA full text>
- 2. PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism: results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA 1990; 263: 2753-2759.
- 3. British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58: 470-484.
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