Medical Radiology and Radiation Safety. 2026. Vol. 71. № 1
DOI:10.33266/1024-6177-2026-71-1-90-95
O.A. Afukova1, M. Yu. Fedyanin2, 3, 4, A.L. Yudin1, A.S. Vinokurov1, 3, 5,
A.S. Kovaleva3, 6, E.V. Kotova4, N.S. Donchenko3
Accidental Detection of Pulmonary Embolism According To CT in Cancer Patients with Low and Intermediate Risk of Thrombosis – Features of Radiology Diagnosis and Risk Factors
1 N.I. Pirogov Russian National Research Medical University, Moscow, Russia
2 N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
3 Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia
4 N.I. Pirogov National Medical and Surgical Center, Moscow, Russia
5 City Hospital № 24, Moscow, Russia
6 Sechenov First Moscow State Medical University, Moscow, Russia
Contact person: O.A. Afukova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Purpose: To evaluate the factors associated with asymptomatic pulmonary embolism (PE) in oncology patients with low/intermediate risk (Horan scale), as well as to determine the methodological features of CT, which make it possible to identify CT signs of PE in the absence of clinical symptoms.
Material and methods: Out of 104 patients who underwent contrast-enhanced CT, 65 with low and intermediate risk on the Horan scale were selected, in which the data were evaluated: gender, age, ECOG scale, tumor localization and stage, type of antitumor drug therapy, taking glucocorticosteroids and anticoagulants before PE was detected, the timing of PE detection, the presence of thrombosis of any localization, hospitalization in the previous 3 months before PE detection for any reason, surgical benefits, injuries and fractures in the anamnesis, a new coronavirus infection (with laboratory confirmation), radiation therapy, varicose veins of the lower extremities, diabetes mellitus, chronic kidney disease, coronary heart disease, hypertension, the presence of a venous port for chemotherapy. Laboratory parameters were evaluated: the level of hemoglobin, leukocytes, platelets, D-dimer, the risk of thrombosis was assessed according to the following scales: Korana, PROTECHT, CONCO, Vienna CATSCORE, ONCOTEV, COMPASS, as well as survival after PE detection.
Results: When distributing patients according to the risk of thrombosis, when using the COMPASS scale, patients at high risk of thrombosis in this sample were more often identified (87.7 %). The remaining scales considered classified patients at high risk from 9.2 % to 41.5 %. The median overall survival was 16 months. Correlation evaluation of the Horan, PROTECHT, CONCO, Vienna CATSCORE, ONCOTEV, and COMPASS scales revealed that all scales except COMPASS VTE significantly correlated with each other. During the correlation analysis, a moderate (k=0.243) correlation of the COMPASS scale with the PE index (Quanadli) was noted with a significance of p=0.055. The tumor T index correlated (k = –0.288, p=0.025); endocrinotherapy (k=0.283, p=0.025); radiation therapy (k=0.257, p=0.042); an increase in the level of D-Dimer (k=0.309, p=0.015). However, no influence of factors on the PE index was noted during the regression analysis. The most reasonable protocol for CT patient contrast to detect asymptomatic PE is the split-bolus technique.
Keywords: CT, CT-angiopulmonography, split-bolus, contrast enhancement, pulmonary thromboembolism, oncology, thrombosis
For citation: Afukova OA, Fedyanin MYu, Yudin AL, Vinokurov AS, Kovaleva AS, Kotova EV, Donchenko NS. Accidental Detection of Pulmonary Embolism According To CT in Cancer Patients with Low and Intermediate Risk of Thrombosis – Features of Radiology Diagnosis and Risk Factors. Medical Radiology and Radiation Safety. 2026;71(1):90–95. DOI:10.33266/1024-6177-2026-71-1-90-95
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Afukova O.A. – collection and analysis of literary material, writing the text; Fedyanin M.Yu. – development of the research concept. Scientific editing of the text; Yudin A.L. – scientific editing of the text; Vinokurov A.S. – development of the research concept, writing the text; Kovaleva A.S. – development and modification of research methods; Kotova E.A. – statistical data processing; Donchenko N.S. – development of the research design.
Article received: 20.11.2025. Accepted for publication: 25.12.2025.