title: Diagnostic accuracy of single-photon emission tomography ventilation/perfusion lung scan in the diagnosis of pulmonary embolism.
abstract: BACKGROUND
  Planar ventilation/perfusion (V/Q) lung scintigraphy is a validated tool for the diagnosis of pulmonary embolism (PE). Nevertheless, given the high rate of nonconclusive V/Q, further investigation is often necessary. V/Q single-photon emission CT (SPECT) scan could improve V/Q performance, but sparse data are available on its accuracy. This study assessed the diagnostic performance of V/Q SPECT scan in a cohort of consecutive patients with suspected PE.
  
  
  METHODS
  Three hundred twenty-one consecutive patients with a clinical suspicion of PE were prospectively included. Patients suspected of having PE were managed according to a reference diagnostic strategy validated by a 3-month follow-up. In addition to the reference strategy, patients had a V/Q SPECT scan, the results of which were compared with the initial work-up results.
  
  
  RESULTS
  Prevalence of PE was 0 of 41 (0%; 95% CI, 0%-9%), six of 134 (4%; 95% CI, 2%-9%),15 of 36 (42%; 95% CI, 27%-58%), and 28 of 32 (88%; 95% CI, 72%-95%) in the normal, low,intermediate, and high V/Q SPECT scan probability groups, respectively. The combination of V/Q SPECT scan with clinical probability was diagnostic in 88% of patients.
  
  
  CONCLUSIONS
  V/Q SPECT scan results show satisfactory accuracy for PE diagnosis. Validation of dedicated interpretation criteria is required, followed by outcome studies that use V/Q SPECT scan as part of a diagnostic strategy to rule out PE.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT01183026; URL: www.clinicaltrials.gov
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA3878 (GETBO) IFR 148, CHU de la Cavale Blanche, Brest, France; Service de médecine nucléaire, CHU de la Cavale Blanche, Brest, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Le Duc-Pennec
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA3878 (GETBO) IFR 148, CHU de la Cavale Blanche, Brest, France; Service de médecine nucléaire, CHU de la Cavale Blanche, Brest, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Le Roux
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA4324 (ORPHY) IFR 148, Université de Brest, CHU de la Cavale Blanche, Brest, France; Département de cardiologie, CHU de la Cavale Blanche, Brest, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Cornily
authors.affiliation: Service des urgences, CHU de la Cavale Blanche, Brest, France.
authors.forename: Morgan
authors.initials: M
authors.lastname: Jaffrelot
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA3878 (GETBO) IFR 148, CHU de la Cavale Blanche, Brest, France; Département de médecine interne et de pneumologie, CHU de la Cavale Blanche, Brest, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Delluc
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA3878 (GETBO) IFR 148, CHU de la Cavale Blanche, Brest, France; Département de médecine interne et de pneumologie, CHU de la Cavale Blanche, Brest, France.
authors.forename: Luc
authors.initials: L
authors.lastname: de Saint-Martin
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA3878 (GETBO) IFR 148, CHU de la Cavale Blanche, Brest, France; Service de médecine nucléaire, CHU de la Cavale Blanche, Brest, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Guillo
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; Département de médecine interne et de pneumologie, CHU de la Cavale Blanche, Brest, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Le Gal
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA3878 (GETBO) IFR 148, CHU de la Cavale Blanche, Brest, France; Service de médecine nucléaire, CHU de la Cavale Blanche, Brest, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Salaun
authors.affiliation: Université Européenne de Bretagne, CHU de la Cavale Blanche, Brest, France; EA3878 (GETBO) IFR 148, CHU de la Cavale Blanche, Brest, France; Département de médecine interne et de pneumologie, CHU de la Cavale Blanche, Brest, France. Electronic address: christophe.leroyer@chu-brest.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Leroyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015899:Tomography, Emission-Computed, Single-Photon