Agreement between SPECT V/Q scan and CT angiography in patients with high clinical suspicion of PE

Mahdavi, Ramyar; Caronia, Jonathan; Fayyaz, Jazeela; Panagopoulos, Georgia; Lessnau, Klaus; Scharf, Stephen C.; Mina, Bushra; Allred, Charles; DiFabrizio, Larry

doi:10.1007/s12149-013-0753-1

Cited by 15 publications

(12 citation statements)

References 11 publications

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“…Among 100 high-risk patients who required both V/Q SPECT and CT angiography due to an initial indeterminate or negative imaging test despite a high pre-test probability, the agreement between these tests was evaluated [23]. Pulmonary embolism was diagnosed by clinical findings as well as the results of V/Q SPECT and CT angiography.…”

Section: Non-diagnosticmentioning

confidence: 99%

“…Computed tomographic angiography was diagnostic in 10 out of 12 (83 %) patients in whom V/Q SPECT was indeterminate. Ventilation/perfusion SPECT often provides a diagnosis in the presence of an indeterminate CT angiogram in patients with high clinical suspicion of PE, and CT angiography often provides a diagnosis when SPECT is indeterminate [23]. These data suggest that in difficult cases the two modalities can be complementary.…”

Section: Non-diagnosticmentioning

confidence: 99%

“…The sensitivity of V/Q SPECT was higher than that of planar V/Q in every investigation [23, 28-31, 34, 35] (Table 2). The specificity of SPECT CT in some investigations was higher than that of planar V/Q [30,31,34], but it was sometimes the same or nearly the same [29,35] and in some investigations V/Q SPECT showed a lower specificity than planar V/Q [23,28] (Table 2). Reinartz et al used planar images reconstructed from SPECT data [29,30].…”

Section: V/q Spect Compared With Planar V/q Scintigraphymentioning

confidence: 99%

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Critical review of SPECT imaging in pulmonary embolism

Stein

Sostman

Matta

2014

Clin Transl Imaging

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Outcome studies have shown that pulmonary embolism can be safely excluded in patients with negative ventilation/perfusion (V/Q) single-photon emission computed tomography (SPECT). The effective radiation dose of V/Q SPECT is much less than with computed tomographic (CT) pulmonary angiography, which would make it preferable to CT angiography in many young female patients. The accuracy of V/Q SPECT, however, is difficult to assess, because most published investigations are limited by incorporation bias or partial verification bias, as well as other limitations in study design and reporting. Consequently, the accuracy of V/Q SPECT relative to planar V/Q scintigraphy or CT angiography has not been definitively determined. There is need for a prospective investigation of the accuracy of V/Q SPECT with consecutive patients, blinded interpretations, and an independent reference standard, or independent composite reference standard.Keywords Pulmonary embolism Á Venous thromboembolism Á Single-photon emission computed tomography Since the publication of the prospective investigation of pulmonary embolism diagnosis (PIOPED) in 1990 [1], there has been a decline in the use of ventilation/perfusion (V/Q) planar scintigraphy [2] and widespread adoption of computed tomographic (CT) pulmonary angiography for the diagnosis of acute pulmonary embolism (PE) [2]. The development of tomographic radionuclide imaging presents diagnostic possibilities that were not available at the time of publication of the PIOPED. In 2009, together with colleagues, we reviewed the use of single-photon emission computed tomography (SPECT) in acute PE [3]. Numerous observations with SPECT in the 5 years since then prompted us to conduct the present review of its potential role in evaluating patients with PE. One aim of this review is to present data that will allow physicians to make informed choices regarding the use of SPECT in patients with suspected PE.We searched PubMed using the following search terms: SPECT PE matched with accuracy (20 results), sensitivity (34 results), specificity (39 results); SPECT pulmonary embolism matched with accuracy (35 results), sensitivity (78 results), specificity (80 results); single-photon emission computed tomography pulmonary embolism matched with accuracy (30 results), sensitivity (71 results), specificity (72 results); single-photon emission computed tomography pulmonary embolism (174 results); SPECT pulmonary embolism (197 results). We also checked the references of relevant studies to identify additional investigations. The inclusion criteria were: studies in all languages related to the accuracy of SPECT that included [10 patients suspected of having acute PE and showed or allowed the reader to calculate sensitivity, specificity, and results of clinical follow-up. We identified 21 such articles and 2 preliminary articles with fewer patients that were of interest. Some addressed more than one topic.

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Section: Non-diagnosticmentioning

confidence: 99%

Section: Non-diagnosticmentioning

confidence: 99%

Section: V/q Spect Compared With Planar V/q Scintigraphymentioning

confidence: 99%

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Critical review of SPECT imaging in pulmonary embolism

Stein

Sostman

Matta

2014

Clin Transl Imaging

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“…Bajc et al and a prospective study by Gutte et al showed that V/P SPECT has higher sensitivity and specificity and less non-diagnostic findings than MDCT [10,14]. A recent study by Mahdavi et al showed that in the presence of an indeterminate CT angiography (CTA) in patients with high clinical suspicion of PE, V/P SPECT often provides a diagnosis [15].…”

Section: Comparison With Mdctmentioning

confidence: 99%

Good clinical practice in pulmonary embolism diagnosis: where do we stand today?

Bajc¹,

Maffioli²,

Miniati³

2013

Eur J Nucl Med Mol Imaging

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“…MAA in labeling with 99m Tc, 99m Tc-MAA, has been introduced for different use such as perfusion lung imaging to assess the presence of pulmonary emboli, radionuclide venography to identify lower extremity venous thrombosis and assessment of peritoneovenous shunt patency [7,8]. Due to the special characteristics of 68 Ga and MAA, it seems 68 Ga-MAA complex can be a potential PET imaging agent [9].…”

Section: Introductionmentioning

confidence: 99%