Comparison of V/Q SPECT and planar V/Q lung scintigraphy in diagnosing acute pulmonary embolism

Gutte, Henrik; Mortensen, Jann; Jensen, C. E.; Recke, Peter von der; Petersen, Claus Leth; Kristoffersen, Ulrik Sloth; Kjær, Andreas

doi:10.1097/mnm.0b013e3283336747

Cited by 92 publications

(79 citation statements)

References 11 publications

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“…Similar results have been found by others (Gutte et al, 2010;Reinartz et al, 2001). SPECT eliminates superimposed structures, clarifying segmental and sub-segmental nature of perfusion defects caused by PE.…”

Section: Sensitivity and Specificity Of V/p Spect And Other Methodolosupporting

confidence: 92%

Quantitative Ventilation/Perfusion Tomography: the Foremost Technique for Pulmonary Embolism Diagnosis

Bajc¹,

Jögi²

2012

Pulmonary Embolism

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Section: Sensitivity and Specificity Of V/p Spect And Other Methodolosupporting

confidence: 92%

Quantitative Ventilation/Perfusion Tomography: the Foremost Technique for Pulmonary Embolism Diagnosis

Bajc¹,

Jögi²

2012

Pulmonary Embolism

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“…This led to its adoption as the standard method, by confirming the superiority of tomography over planar imaging with excellent interobserver agreement in identifying perfusion defects at the subsegmental level [6]. The advantage of tomographic over planar images for PE detection was recently confirmed in human studies [7].…”

Section: Historical Evolution Of Lung Scintigraphymentioning

confidence: 97%

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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“…These data suggest that in difficult cases the two modalities can be complementary. Gutte [34] CT angio, V/Q SPECT, V/Q planar, clinical, leg US, and follow-up Weinmann et al performed an investigation that included only patients who had non-diagnostic planar V/Q scans and required SPECT to confirm the reference standard diagnosis if CT angiography showed only a single subsegmental defect [24]. The sensitivity of SPECT was 15 out of 19 (79 %) and the specificity was 62 out of 75 (83 %) ( Table 1) Palla et al obtained conventional pulmonary angiograms in 20 patients with abnormal planar perfusion scans.…”

Section: Non-diagnosticmentioning

confidence: 99%

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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Comparison of V/Q SPECT and planar V/Q lung scintigraphy in diagnosing acute pulmonary embolism

Abstract: We conclude that V/Q SPECT has a superior diagnostic performance compared with planar V/Q scintigraphy and should be preferred when diagnosing PE.

Cited by 92 publications

References 11 publications

Quantitative Ventilation/Perfusion Tomography: the Foremost Technique for Pulmonary Embolism Diagnosis

Quantitative Ventilation/Perfusion Tomography: the Foremost Technique for Pulmonary Embolism Diagnosis

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

Critical review of SPECT imaging in pulmonary embolism

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