A Prospective, Comparative Study of Ventilation–Perfusion Planar Imaging and Ventilation–Perfusion SPECT for Chronic Thromboembolic Pulmonary Hypertension

Abstract

The study compared the diagnostic performance of Planar Ventilation/perfusion (V/Q) and V/Q Single-photon computed tomography (SPECT), and determined whether combining perfusion scanning with low-dose computed tomography (Q-LDCT) may be equally effective in a prospective study of patients with chronic thromboembolic pulmonary hypertension (CTEPH) patients. Background V/Q scanning is recommended for excluding CTEPH during the diagnosis of pulmonary hypertension

A Feasibility Study on Using Single-Photon Emission Computed Tomography Pulmonary Perfusion/Ventilation Imaging for the Diagnosis of Chronic Thromboembolic Pulmonary Hypertension and Patient Risk Assessment

“…This opinion is supported by previous studies. 5,16 Abbreviations: NPSPDs, number of pulmonary segments with perfusion defects; PPDs%, the percentage of pulmonary perfusion defect score.…”

Automatic Diagnosis of Chronic Thromboembolic Pulmonary Hypertension Based on Volumetric Data from SPECT Ventilation and Perfusion Images

“…Regarding the metric and results of the present work, it needs to be noted that quantitative volumetric data of both ventilation and perfusion scans were not evaluated in any of the referenced studies [10][11][12][13][14][15][16][17]. The main image analysis method is a qualitative assessment of the perfusion SPECT and segmental or subsegmental defects, as defined in the clinical guidelines of the EANM [3].…”

“…For example, Johns et al [10] determined a positive or negative diagnosis for CTEPH based on visual interpretation of perfusion SPECT images. Wang et al [15] also classified the images visually as positive or negative for PE, as the clinical guidelines do not differentiate between acute PE and CTEPH. In Renapurkar et al [11], the defects in the perfusion SPECT scan are graded on a four-point scale and only planar V/Q scanning is used for quantitative measurements.…”

“…The ventilation and perfusion of the lungs on SPECT V/Q images for the diagnosis and evaluation of treatment response of CTEPH is usually based on a qualitative analysis of the image data. SPECT V/Q is also used as a reference in the evaluation of other diagnostic techniques [10][11][12][13][14][15][16]. The quantitative analysis of lung perfusion on SPECT images by volumetric data has previously been proposed [17].…”

Pulmonary angioplasty: A step further in the continuously changing landscape of chronic thromboembolic pulmonary hypertension management

“…According to the latest diagnostic algorithm from the European Society of Cardiology (ESC) [24], patients with intermediate or high probability of PH at echocardiography benefit from radionuclide ventilation-perfusion (V/Q) lung scintigraphy, which accurately detects suggestive abnormalities, typically large mismatched perfusion defects. Sensitivity and specificity are excellent (>90 %) with both planar V/Q, and V/Q single-photon computed tomography (SPECT) [34]. Additionally, due to its nearly perfect negative predictive value, V/Q can safely exclude CTEPH and avoid unnecessary additional diagnostic tests.…”