Generation of planar images from lung ventilation/perfusion SPECT

Bailey, Dale L.; Schembri, Geoffrey; Harris, Benjamin; Cooper, Robert; Roach, Paul

doi:10.1007/s12149-007-0120-1

Cited by 24 publications

(9 citation statements)

References 20 publications

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“…Comparisons of reprojected images with standard planar V/Q scans showed similar detail and distribution of radiopharmaceuticals (39). It was believed that reprojected images could replace true planar images with no loss of diagnostic sensitivity (39). Subsequent comparisons showed that reprojected reconstructions resulted in more matched defects but no differences in interpretation from true planar V/Q scans (40).…”

Section: Technical Studiesmentioning

confidence: 95%

“…Two methods for producing planarlike V/Q scans from SPECT V/Q scans have been described: the angular summed method (22,23) and reprojected scans (39). Comparisons of reprojected images with standard planar V/Q scans showed similar detail and distribution of radiopharmaceuticals (39). It was believed that reprojected images could replace true planar images with no loss of diagnostic sensitivity (39).…”

Section: Technical Studiesmentioning

confidence: 99%

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SPECT in Acute Pulmonary Embolism

Stein¹,

Freeman²,

Sostman³

et al. 2009

J Nucl Med

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The purpose of this review was to evaluate the accuracy of SPECT in acute pulmonary embolism. Sparse data are available on the accuracy of SPECT based on an objective reference test. Several investigations were reported in which the reference standard for the diagnosis of pulmonary embolism was based in part on the results of SPECT or planar ventilation-perfusion (V/Q) imaging. The sensitivity of SPECT in all but one investigation was at least 90%, and specificity also was generally at least 90%. The sensitivity of SPECT in 4 of 5 investigations was higher than that of planar V/Q imaging. The specificity of SPECT was generally higher, equal, or only somewhat lower than that of planar V/Q imaging. Most investigators reported nondiagnostic SPECT V/Q scans in no more than 3% of cases. Methods of obtaining SPECT images, methods of obtaining planar V/Q images, and the criteria for interpretation varied. The general impression is that SPECT is more advantageous than planar V/Q imaging.

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Section: Technical Studiesmentioning

confidence: 95%

Section: Technical Studiesmentioning

confidence: 99%

SPECT in Acute Pulmonary Embolism

Stein¹,

Freeman²,

Sostman³

et al. 2009

J Nucl Med

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“…Although Bailey et al have described a technique using reprojection (28), many of the commercial vendors offer a simpler approach using an angular summing technique (14). With this approach, images are generated by summing several consecutive projections from the SPECT acquisition.…”

Section: V/q Spect Techniquementioning

confidence: 99%

V/Q Scanning Using SPECT and SPECT/CT

2013

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) advantages and shortcomings of planar versus SPECT V/Q scanning, (2) advantages and disadvantages of CT pulmonary angiography versus V/Q SPECT in the investigation of pulmonary embolism, and (3) an overview of image acquisition, processing, display, and reporting of V/Q SPECT studies.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, participants can access this activity through the SNMMI Web site (http:// www.snmmi.org/ce_online) through September 2016.Planar ventilation-perfusion ( V/Q) scanning is often used to investigate pulmonary embolism; however, it has well-recognized limitations. SPECT overcomes many of these through its ability to generate 3-dimensional imaging data. V/Q SPECT has higher sensitivity, specificity, and accuracy than planar imaging and a lower indeterminate rate. SPECT allows for new ways to display and analyze data, such as parametric V/Q ratio images. Compared with CT pulmonary angiography, SPECT has higher sensitivity, a lower radiation dose, fewer technically suboptimal studies, and no contrast-related complications. Any nuclear medicine department equipped with a modern hybrid scanner can now perform combined V/Q SPECT with CT (using low-dose protocols) to further enhance diagnostic accuracy. V/Q SPECT (with or without CT) has application in other pulmonary conditions and in research. Si nce its first description by Wagner et al. in 1964 (1), the planar lung scan has been one of the most commonly performed studies in nuclear medicine. It is, however, a test with significant limitations, which have had an adverse impact on its reputation (2,3). Because planar imaging is a 2-dimensional technique, it has inherent limitations, especially related to overlap of anatomic segments. Assigning defects to specific lung segments is often difficult, and the variability in segment size and shape between patients makes accurate determination of the extent of embolic involvement in individual segments a challenge (2). Embolic defects may not be detected if there is shine-through from underlying lung segments with normal perfusion, thus resulting in an underestimation of the extent of perfusion loss (4). Furthermore, the medial basal segment of the right lower lobe is often not visualized on planar scans (2,5). Added to these factors is the widespread use of probabilistic reporting criteria, and a relatively high indeterminate rate, both of which have caused significant dissatisfaction among referring physicians (6,7). ...

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“…Reprojected planar images were constructed at a later time, at the same views as the traditional planars, using the reprojection algorithm supplied with the processing software (Hybrid Recon Lung, v1.0.15). The basis of this method has been described elsewhere [10]. In short, the scatter window was used to generate the outline of the patient body and the photopeak was used to outline the lungs.…”

Section: Scintigraphic Imagingmentioning

confidence: 99%