Zamara Sohail, Muhammad Abdullah, Ali Asghar, Saira Yasmin, Raheel Ahmad


Background: Computer tomography pulmonary angiogram (CTPA) is the recommended diagnostic method for individuals suspected of having pulmonary embolism (PE). The objective of this study was to determine the degree of concordance and discordance of CTPA interpretations for diagnosis of PE between the resident and consultant radiologist at Rehman Medical Institute, Peshawar.

Materials & Methods: This was a cross sectional study conducted between 1st January 2022 and 30th June 2022 at radiology department of the Rehman Medical Institute in Peshawar. A consultant radiologist’s report was contrasted to the first interpretation of the on-call radiology resident. For pulmonary embolism, studies were categorized as positive, negative, or equivocal. Inter-rater agreement was examined using an unweighted Kappa coefficient with a 95% confidence range. SPSS version 26 was used for data analysis.

Results: Fifty successive CTPA tests were examined. The results showed that consultant interprets 43 (86%) of the studies as negative for PE. Residents, on the other hand, interpret 40 (80%) of them negatives. The concordance rate was 88%, with moderate statistical agreement, kappa = 0.597: 95% CI, 0.187- 0.765. The discordance rate was 12%. Regarding cardiac chambers, the consultant reported 10 (20%) with cardiomegaly. However, residents interpreted only 2 (4%) of them cardiomegaly. Overall concordance rate was 82%, with weak kappa = 0.350: 95% CI, 0.00- 0.688. In 18% of the cases, there was discordance.

Conclusion: Resident radiologist can provide high level of interpretation of CTPA for PE, achieving moderate concordance with consultant radiologist.


Pulmonary embolism; CTPA; Contrast; Radiologist; Residents.

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