A comparison of single-photon emission CT lung scintigraphy and CT pulmonary angiography for the diagnosis of pulmonary embolism.
BACKGROUND
This study compared single-photon emission CT (SPECT) ventilation/perfusion (V/Q) scintigraphy with multislice CT pulmonary angiography (CTPA).


METHODS
In a prospective, observational study, 100 patients who were >or= 50 years of age were recruited. Seventy-nine patients underwent both diagnostic 16-detector CTPA, and planar and SPECT V/Q scintigraphy. The agreement between the CTPA and the SPECT V/Q scintigraphy for the diagnosis of pulmonary embolism (PE) was calculated. The sensitivity and specificity of blinded SPECT scintigraphy reporting was calculated against a reference diagnosis made by a panel of respiratory physicians that was provided with CTPA and planar V/Q scintigraphy reports, clinical information, and 3-month follow-up data.


RESULTS
The observed percentage of agreement between SPECT V/Q scintigraphy and CTPA data for the diagnosis of PE was 95%. When calculated against the respiratory physicians' reference diagnosis, SPECT V/Q scintigraphy had a sensitivity of 83% and a specificity of 98%.


CONCLUSIONS
This study indicates that SPECT V/Q scintigraphy is a viable alternative to CTPA for the diagnosis of PE and has potential advantages in that it was feasible in more patients and had fewer contraindications; lower radiation dose; and, arguably, fewer nondiagnostic findings than CTPA.


BACKGROUND
Australian New Zealand Clinical Trials Registry Registration Number: ACTRN12609000089235.
Miles
Susan
S
Department of General Medicine, Calvary Mater Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia. Electronic address: susan.miles@mater.health.nsw.gov.au.
Rogers
Kerry M
KM
Department of Nuclear Medicine, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.
Thomas
Paul
P
Department of Nuclear Medicine, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia; Department of Queensland PET Service, Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Soans
Barry
B
Department of Radiology, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.
Attia
John
J
Department of Hunter Medical Research Institute, Department of Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Department of Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia.
Abel
Christian
C
Department of Radiology, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.
Holt
Elizabeth
E
Department of Radiology, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.
D'Este
Catherine A
CA
Department of Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia.
Hensley
Michael J
MJ
Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Department of School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*