title: Pulmonary Scintigraphy for the Diagnosis of Acute Pulmonary Embolism: A Survey of Current Practices in Australia, Canada, and France.
abstract: There are currently no data published regarding the proportion of nuclear medicine centers using SPECT or SPECT/CT rather than planar ventilation/perfusion (V/Q) imaging in patients with suspected acute pulmonary embolism (PE). Furthermore, the reporting criteria used for interpretation of both planar and SPECT V/Q scans are variable and data are lacking regarding which criteria are commonly used in various centers. The aim of this study was to assess current practices regarding the performance and interpretation of lung scintigraphy across 3 different countries.
  
  
  METHODS
  A short online survey composed of simple multiple-choice questions was distributed to nuclear medicine departments in Australia, Canada, and France during the period April to December 2014. The survey covered image acquisition, interpretation criteria for SPECT and planar images, and use of pseudoplanar images and radiopharmaceuticals. Information was initially solicited by 2 sets of e-mails, which pointed to the survey internet link. Departments were subsequently contacted by telephone. A single response per department was consolidated.
  
  
  RESULTS
  Three hundred thirty-one responses were collected (Australia, 74; Canada, 48; and France, 209). Twenty-eight percent of centers indicated use of V/Q planar imaging alone whereas 72% of centers included some form of SPECT in their acquisition protocol for evaluation of PE, specifically V/Q SPECT in 36%, V/Q SPECT/CT in 29%, Q SPECT/CT in 2%, and both V/Q planar and SPECT in 5%, with a strong variability among countries. The most commonly used criteria for SPECT interpretation were the those of the European Association of Nuclear Medicine (60%). Criteria used for planar interpretation were heterogeneous (European Association of Nuclear Medicine criteria, 35%; Prospective Investigation of Pulmonary Embolism Diagnosis study, 29%; no standardized criteria, 21%). Sixty-three percent of departments used pseudoplanar images in addition to SPECT images.
  
  
  CONCLUSIONS
  In the 3 countries surveyed, SPECT has largely replaced planar imaging for evaluation of PE, with almost half of the SPECT studies incorporating a CT acquisition. Criteria used for interpretation are inconsistent, especially for planar imaging.
authors.affiliation: Université Européenne de Bretagne, Université de Brest, EA3878 (GETBO) IFR 148, CHRU de Brest, Service de Médecine Nucléaire, Brest, France Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia pierre-yves.leroux@chu-brest.fr.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Le Roux
authors.affiliation: The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Pelletier-Galarneau
authors.affiliation: Université Européenne de Bretagne, Université de Brest, EA3878 (GETBO) IFR 148, CHRU de Brest, Service de Médecine Nucléaire, Brest, France.
authors.forename: Romain
authors.initials: R
authors.lastname: De Laroche
authors.affiliation: Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hofman
authors.affiliation: The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
authors.forename: Lionel S
authors.initials: LS
authors.lastname: Zuckier
authors.affiliation: Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Roach
authors.affiliation: CHU de Grenoble, Grenoble, France; and.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Vuillez
authors.affiliation: Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Hicks
authors.affiliation: The Ottawa Hospital, University of Ottawa, Ottawa, Canada Université Européenne de Bretagne, Université de Brest, INSERM CIC 05-02 IFR148, CHRU de Brest, Département de Médecine Interne et de Pneumologie, Brest, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Le Gal
authors.affiliation: Université Européenne de Bretagne, Université de Brest, EA3878 (GETBO) IFR 148, CHRU de Brest, Service de Médecine Nucléaire, Brest, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Salaun
mesh_terms: D001315:Australia; D002170:Canada; D003952:Diagnostic Imaging / Q000379:methods / Q000639:trends; D005060:Europe; D005602:France; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D064847:Multimodal Imaging / Q000379:methods*; D009683:Nuclear Medicine / Q000379:methods* / Q000639:trends; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014692:Ventilation-Perfusion Ratio
keywords: practices; pulmonary embolism; single photon emission computed tomography; ventilation perfusion scintigraphy