SPECT/CT in V/Q Scanning

Roach, Paul; Gradinscak, Denis J.; Schembri, Geoffrey; Bailey, Elizabeth; Willowson, Kathy; Bailey, Dale L.

doi:10.1053/j.semnuclmed.2010.07.005

Cited by 66 publications

(42 citation statements)

References 53 publications

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“…In addition, there are much less data validating the use of V/Q SPECT/CT as compared with V/Q SPECT alone. Studies have consistently reported a higher specificity of the test (24,33), which may be of relevance in the setting of the increasing concern about a possible overtreatment of PE and a trend toward the use of extended duration of anticoagulation therapy (34). An additional low-dose CT also allows the detection of alternative diagnoses, which has been reported as an advantage of CTPA (35).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France

et al. 2015

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There are currently no data published regarding the proportion of nuclear medicine centers using SPECT or SPECT/CT rather than planar ventilation/perfusion (V/Q) imaging in patients with suspected acute pulmonary embolism (PE). Furthermore, the reporting criteria used for interpretation of both planar and SPECT V/Q scans are variable and data are lacking regarding which criteria are commonly used in various centers. The aim of this study was to assess current practices regarding the performance and interpretation of lung scintigraphy across 3 different countries. Methods: A short online survey composed of simple multiple-choice questions was distributed to nuclear medicine departments in Australia, Canada, and France during the period April to December 2014. The survey covered image acquisition, interpretation criteria for SPECT and planar images, and use of pseudoplanar images and radiopharmaceuticals. Information was initially solicited by 2 sets of e-mails, which pointed to the survey internet link. Departments were subsequently contacted by telephone. A single response per department was consolidated. Results: Three hundred thirty-one responses were collected (Australia, 74; Canada, 48; and France, 209). Twenty-eight percent of centers indicated use of V/Q planar imaging alone whereas 72% of centers included some form of SPECT in their acquisition protocol for evaluation of PE, specifically V/Q SPECT in 36%, V/Q SPECT/CT in 29%, Q SPECT/CT in 2%, and both V/Q planar and SPECT in 5%, with a strong variability among countries. The most commonly used criteria for SPECT interpretation were the those of the European Association of Nuclear Medicine (60%). Criteria used for planar interpretation were heterogeneous (European Association of Nuclear Medicine criteria, 35%; Prospective Investigation of Pulmonary Embolism Diagnosis study, 29%; no standardized criteria, 21%). Sixty-three percent of departments used pseudoplanar images in addition to SPECT images. Conclusion: In the 3 countries surveyed, SPECT has largely replaced planar imaging for evaluation of PE, with almost half of the SPECT studies incorporating a CT acquisition. Criteria used for interpretation are inconsistent, especially for planar imaging. It has been more than 50 y since lung scintigraphy was first described for the diagnosis of pulmonary embolism (PE). Since that time, the examination has evolved greatly with respect to equipment, radiopharmaceuticals, and imaging algorithms, along with perception among nuclear medicine and referring physicians.Although performed 25 y ago, using imaging equipment and ventilation agents that would currently be considered obsolete in most centers, the Prospective Investigation of Pulmonary Embolism Diagnosis study (PIOPED) study remains the landmark accuracy study in the eyes of many clinicians (1). The diagnostic performance of planar ventilation/perfusion (V/Q) scanning was then insufficient to allow a binary reporting approach (PE or no PE). Therefore, probabilistic reporting criteria were proposed, resulting...

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Section: Discussionmentioning

confidence: 99%

Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France

et al. 2015

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“…This technique has potential application in the presurgical evaluation of patients undergoing lung volume reduction surgery (30), in the assessment of pulmonary reserve in lung cancer patients before radiotherapy or surgery, and in the advancement of understanding about airway diseases such as chronic obstructive pulmonary disease, asthma, and interstitial pulmonary disease (9,31). Further trials to assess regional changes brought about by interventions or treatment, or merely to examine the natural history of a variety of pulmonary diseases, would be of interest.…”

Section: Discussionmentioning

confidence: 99%

“…In a large prospective series, V/Q SPECT had a high negative predictive value for excluding PE (8). The advent of hybrid SPECT/CT devices further improved diagnostic accuracy by enabling anatomic characterization of scintigraphic abnormalities (9,10). The CT component also assists diagnosis by identifying nonembolic causes of the symptoms of shortness of breath and pleuritic pain that raise suspicion of PE.…”

mentioning

confidence: 99%

⁶⁸Ga PET/CT Ventilation–Perfusion Imaging for Pulmonary Embolism: A Pilot Study with Comparison to Conventional Scintigraphy

Hofman¹,

Beauregard²,

Barber³

et al. 2011

J Nucl Med

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Ventilation-perfusion (V/Q) scintigraphy is established for regional assessment of lung function in a variety of diseases, including pulmonary embolism (PE). PET/CT may further improve the accuracy and utility of V/Q imaging because of its superior technical characteristics. This pilot study assessed the feasibility of performing V/Q PET/CT and compared diagnostic utility with conventional V/Q imaging in patients with clinical suspicion of PE. Methods: Ten patients undergoing conventional V/Q imaging were prospectively recruited. PET/ CT V/Q imaging was performed after inhalation of 68 Ga-carbon nanoparticles ("Galligas") and administration of 68 Ga-macroaggregated albumin. Blinded to the results of the other study, SPECT/CT (n 5 9) or SPECT (n 5 1) images and PET/CT images were graded by a predefined scoring system for scan quality. The number of matched or unmatched defects and diagnosis were also measured and compared with a final diagnosis. Results: PET image quality was equivalent or superior to SPECT in all patients, with more homogeneous radiotracer distribution for both ventilation and perfusion studies (P , 0.01). Based on conventional V/Q imaging, the diagnosis was acute PE in 2 patients and no PE in 7 patients, and the imaging results were nondiagnostic in 1 patient. The PET/CT diagnosis was concordant in 8 patients, and these studies demonstrated a similar number and distribution of matched and unmatched defects. In 1 discordant case, a patient with a SPECT/CT study that was nondiagnostic because of severe airway disease showed no PE on PET/CT. In another, the diagnosis of PE established on SPECT/CT was not reported on PET/CT 2 d later, possibly because of interval clot lysis or migration. Conclusion: This intraindividual comparative study demonstrated that V/Q PET/CT with 68 Ga-labeled radiotracers can be performed in clinical practice. Compared with conventional V/Q imaging, advantages include higher-resolution, fully tomographic images with potentially better regional quantitation of lung function. The short half-life of 68 Ga also enables more flexible acquisition protocols with the option of performing ventilation studies selectively on patients with abnormal perfusion. On the basis of our results, further studies are indicated to assess whether V/Q PET/CT can improve diagnostic algorithms for patients with suspected PE. Vent ilation-perfusion (V/Q) scintigraphy allows assessment of regional lung function in a variety of diseases. Most studies are performed to assess patients with suspected pulmonary embolism (PE) because presenting symptoms and signs are variable and insufficient for a clinical diagnosis. The Prospective Investigation of Pulmonary Embolism Diagnosis study (1), designed in 1983, established V/Q imaging as the standard of care at the time. V/Q imaging has improved in the past 3 decades because of major advances in image acquisition, reconstruction, and analysis techniques. The use of 99m Tc-labeled carbon nanoparticles (Technegas; Cyclopharm) has improved the assessment of ventil...

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“…stratejiler önerilmiştir. Tek foton emisyon bilgisayarlı tomografi (SPECT) V/P ile toplanan multiplanar görün-tülerle tanısal olmayan tarama sıklığını azaltabileceği gösterilmiştir (17)(18)(19).…”

Section: Direkt Katater Pulmoner Anjiografiunclassified

Diagnostic Imaging in Acute Pulmonary Embolism

Christiansen

2014

J Chest Dis Crit Care

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The clinical diagnosis of acute pulmonary embolism (APE) is difficult because of the variable and non-specific symptoms. Diagnosis is made together by clinics and imaging methods. Rapid and accurate diagnosis is important in preventing mortality and also complications related to anticoagulant therapy as well. Computed tomography (CT) pulmonary angiography and ventilation / perfusion scintigraphy are the most commonly used diagnostic imaging methods. Nowadays, new diagnostic methods like dualenergy CT pulmonary angiography, single photon emission computed tomography (SPECT) and SPECT-CT are increasingly used in clinical practice. The purpose of this paper is to discuss the advantages and disadvantages of imaging methods in the diagnosis of acute PE and assess their clinical use.

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SPECT/CT in V/Q Scanning

Cited by 66 publications

References 53 publications

Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France

Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France

⁶⁸Ga PET/CT Ventilation–Perfusion Imaging for Pulmonary Embolism: A Pilot Study with Comparison to Conventional Scintigraphy

Diagnostic Imaging in Acute Pulmonary Embolism

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SPECT/CT in V/Q Scanning

Cited by 66 publications

References 53 publications

Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France

Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France

68Ga PET/CT Ventilation–Perfusion Imaging for Pulmonary Embolism: A Pilot Study with Comparison to Conventional Scintigraphy

Diagnostic Imaging in Acute Pulmonary Embolism

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⁶⁸Ga PET/CT Ventilation–Perfusion Imaging for Pulmonary Embolism: A Pilot Study with Comparison to Conventional Scintigraphy