An audit of ventilation and perfusion SPECT reporting for the diagnosis of pulmonary embolism in a tertiary cardiothoracic centre

Abstract

The aim of the study was to identify reporting patterns of ventilation and perfusion single‐photon emission computed tomography (V/Q SPECT) scans done in our department over 3 months in 2016. Factors impacting on reporting and patient groups that would most benefit from the addition of low‐dose computed tomography (CT) to V/Q SPECT were analysed. Among 178 patients, 173 (97.2%) had a definitive (positive/negative) report and 2.8% had an equivocal report. As the majority of the equivocal reports were seen in patients aged ≥70 years, we believe that addition of low‐dose CT with V/Q SPECT to this patient group will reduce the non‐diagnostic rate.

Ventilation-perfusion scan for diagnosing pulmonary embolism: do chest x-rays matter?

“…This is consistent with other audits of V/Q use and is likely due to clinician concern regarding radiation risk of breast cancer and use during pregnancy [41]. Low-dose CT is routinely used when V/Q SPECT is performed in patients 70 years or older in our unit based on a prior published work [42]. Although it was used more frequently in the abnormal CXR group, only 4 patients had the diagnosis of PE made with the combination modalities which does not significantly affect the validity of the results.…”

Apples and oranges in pulmonary embolism imaging

“…Our experience is that it may be most helpful with older populations, especially with pulmonary parenchymal abnormality which may result in heterogeneity of radiotracer uptake on V/Q scan. 4 However, more recent literature suggests that relatively unsullied pulmonary parenchyma (as reflected, for example, in normality of chest X-ray) is not truly a pre-requisite for a V/Q scan given that it presently utilises single-proton emission computed tomography. 5…”