Comparison of V/Q SPECT and planar V/Q lung scintigraphy in diagnosing acute pulmonary embolism.
OBJECTIVE
Planar ventilation/perfusion (V/Q) scintigraphy is currently the standard method for the diagnosis of pulmonary embolism (PE) in most nuclear medicine centers. However, recent studies have shown a superior sensitivity and specificity when applying V/Q single photon emission computed tomography (SPECT) in diagnosing PE. This study evaluated the diagnostic performance of three-dimensional V/Q SPECT in comparison with planar V/Q scintigraphy.


METHODS
Consecutive patients suspected of acute PE from June 2006 to February 2008 were referred to the Department of Nuclear Medicine at Frederiksberg Hospital, Denmark to a V/Q SPECT, as the first-line imaging procedure. Patients with positive D-dimer (>0.5 mg/l) or after clinical assessment with a Wells score of more than 2 were included and had a V/Q SPECT, low-dose CT, planar V/Q scintigraphy, and pulmonary multidetector computer tomography angiography performed the same day. Ventilation studies were performed using Kr. Patient follow-up was at least 6 months.


RESULTS
A total of 36 patient studies were available for analysis, of which 11 (31%) had PE. V/Q SPECT had a sensitivity of 100% and a specificity of 87%. Planar V/Q scintigraphy had a sensitivity of 64% and a specificity of 72%.


CONCLUSIONS
We conclude that V/Q SPECT has a superior diagnostic performance compared with planar V/Q scintigraphy and should be preferred when diagnosing PE.
Gutte
Henrik
H
Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Denmark. henrik.gutte@rh.regionh.dk
Mortensen
Jann
J
Jensen
Claus Verner
CV
von der Recke
Peter
P
Petersen
Claus Leth
CL
Kristoffersen
Ulrik Sloth
US
Kjaer
Andreas
A
D000368:Aged; D000792:Angiography; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D055420:Perfusion Imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012123:Pulmonary Ventilation; D011829:Radiation Dosage; D015899:Tomography, Emission-Computed, Single-Photon; D014680:Veins / Q000000981:diagnostic imaging