Three-year clinical experience with VQ SPECT for diagnosing pulmonary embolism: diagnostic performance.
Ventilation-perfusion (VQ) single-photon emission computed tomography (SPECT) comprised the administration of SmartVent (n=386) or Technegas (n=1564) and 200 MBq (99m)Tc-MAA. 1406 scans were normal, 462 showed PE, 61 showed a singular subsegmental mismatched defect, 21 scans were non-diagnostic. 26% of scans performed with Technegas showed PE, compared to 15% with SmartVent. VQ SPECT had a sensitivity of 95.7%, specificity 98.6%, positive predictive value 95.7%, negative predictive value 98.6%. A normal VQ SPECT scan implied a more than ten-fold lower cause-specific mortality (1 in 1406) than a scan showing PE (1 in 116). NPV of a negative D-dimer was 94.3%.
Department of Nuclear Medicine, Derriford Hospital, Plymouth, United Kingdom. Electronic address: thomas.gruning@nhs.net.
Thomas
T
Grüning
Department of Nuclear Medicine, Derriford Hospital, Plymouth, United Kingdom.
Brent E
BE
Drake
Department of Nuclear Medicine, Derriford Hospital, Plymouth, United Kingdom.
Sally L
SL
Farrell
Department of Haematology, Derriford Hospital, Plymouth, United Kingdom.
Tim
T
Nokes
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014692:Ventilation-Perfusion Ratio
D019275:Radiopharmaceuticals; C056708:Technegas; D013670:Sodium Pertechnetate Tc 99m
Fibrin fragment D; Multidetector computed tomography; Pulmonary embolism; Tomography, emission-computed, single-photon; Ventilation-perfusion scan