title: The accuracy of V/Q SPECT in the diagnosis of pulmonary embolism: a meta-analysis.
abstract: BACKGROUND
  Ventilation perfusion single photon emission computed tomography (V/Q SPECT) and CT pulmonary angiography have all been used in the diagnosis of acute PE. Previous studies have shown higher sensitivity and specificity and a marked decrease in the non-diagnostic rate of V/Q SPECT than planar scan.
  
  
  OBJECTIVE
  To systematically review and perform a meta-analysis of published data on the performance of V/Q SPECT in the diagnosis of acute PE.
  
  
  METHODS
  A comprehensive computer search was conducted on literature published through 31 December 2013 in an effort to find relevant articles on the diagnostic performance of V/Q SPECT in the diagnosis of PE patients. Pooled sensitivity, specificity, negative likelihood ratio (LR), and positive LR, the area under the receiver-operating characteristic (ROC) curve of V/Q SPECT in the diagnosis of PE patients were calculated.
  
  
  RESULTS
  Nine studies, comprising a total sample size of 3454 patients, were included in our meta-analysis. The pooled sensitivity, specificity of V/Q SPECT in the diagnosis of acute PE patients, calculated on a per-patient-based analysis, was 96% (95% confidence interval [CI], 95-97%), 97% (95% CI, 96-98%). The pooled negative LR, positive LR of V/Q SPECT in acute PE patients was 0.06 (range, 0.02-0.19) and 16.64 (range, 9.78-31.54). The area under the ROC curve of V/Q SPECT in the diagnosis of acute PE patients was 0.99 on a per-patient-based analysis.
  
  
  CONCLUSIONS
  V/Q SPECT is an accurate method in acute PE patients with high sensitivity and high specificity in the diagnosis of PE.
authors.affiliation: Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Kan
authors.affiliation: Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Leilei
authors.initials: L
authors.lastname: Yuan
authors.affiliation: Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Jacqui K
authors.initials: JK
authors.lastname: Meeks
authors.affiliation: Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Chunlin
authors.initials: C
authors.lastname: Li
authors.affiliation: Emergency Department, Shanxi Provincial Hospital, Taiyuan, Shanxi, PR China.
authors.forename: Wencao
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China nmyangjigang@gmail.com ccmucpmu@gmail.com.
authors.forename: Jigang
authors.initials: J
authors.lastname: Yang
mesh_terms: D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
keywords: Pulmonary embolism; SPECT; perfusion; ventilation