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February 20, 1967


JAMA. 1967;199(8):576. doi:10.1001/jama.1967.03120080110021

There is a wide disparity between the high frequency of pulmonary embolism found at autopsy and the much lower incidence of antemortem diagnosis. Moser and associates1 suggest that this deficiency is due to a "diagnostic gap" between clinical criteria, which provide suggestive but not definitive diagnostic information, and the complex procedure of pulmonary angiography. The angiogram is acceptably precise but it cannot be recommended for routine screening because of the cost, risk, and special skills required. There is the need for a procedure which offers rapid availability of accurate results and is both simple and safe. The pulmonary photoscan utilizing radio-labeled macroaggregates of human serum albumin (R-MAA) fulfills many of these criteria since it is characterized by a considerable degree of safety, simplicity, and speed. A major consideration regarding this procedure is the question of its reliability and sensitivity in detecting nonperfused pulmonary areas. This aspect of the lung photoscan