Good clinical practice in pulmonary embolism diagnosis: where do we stand today?

Bajc, Marika; Maffioli, Lorenzo; Miniati, Massimo

doi:10.1007/s00259-013-2612-7

Cited by 8 publications

(2 citation statements)

References 16 publications

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“…A full issue of Seminars in Nuclear Medicine, guest edited by Australia's Dale Bailey and Paul Roach, clearly makes the case for the improved accuracy of this methodology [48]. More recently, Marika Bajc and her colleagues wrote a superb editorial in the European Journal of Nuclear Medicine and Molecular Imaging extolling the virtues of SPECT V/Q [49]. There is unanimity amongst these authors and others [50] that the sensitivity of V/Q SPECT is superior to that of planar V/Q.…”

Section: The Issue Of Overdiagnosis and Overtreatment: The Significanmentioning

confidence: 99%

Ventilation-perfusion (V/Q) lung scintigraphy: a long journey to a renewed position of prominence in diagnosing pulmonary embolism

Silva

Shah

Freeman

2014

Clin Transl Imaging

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The ventilation-perfusion (V/Q) lung scan has traveled a long, circuitous path since its introduction for the diagnosis of pulmonary embolism (PE) in the 1960s. Its initial credibility was damaged following the publication of the PI-OPED study in 1990 and the emergence of computed tomographic pulmonary angiography (CTPA) in the mid-1990s. A considerable number of advances in both methodology and image interpretation have helped to restore the credibility of V/Q. There has also been considerable concern over the large radiation burden associated with CTPA. The issue of overdiagnosis and overtreatment of small PEs has also received a lot of attention. Although CTPA diagnoses more of these smaller PEs than V/Q, follow-up ''outcomes'' data show that they do not require treatment. The false-negative rates for both procedures are approximately 1 % and not significantly different from one another. Finally, a change from traditional probability interpretations to a simpler and similarly accurate trinary system has made V/Q scintigraphy interpretations easier to understand for the referring clinician.

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Section: The Issue Of Overdiagnosis and Overtreatment: The Significanmentioning

confidence: 99%

Ventilation-perfusion (V/Q) lung scintigraphy: a long journey to a renewed position of prominence in diagnosing pulmonary embolism

Silva

Shah

Freeman

2014

Clin Transl Imaging

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“…The clinical significance of subsegmental PE is unclear and continues to be debated (Carrier et al 2012, Mortensen and Gutte 2014, Bajc et al 2014, Ikesaka and Carrier 2015, Sinzinger et al 2015. In a study by Carrier et al it is concluded that further studies are needed to assess the risk benefit ratio of anticoagulation therapy in patients with subsegmental PE (Carrier et al 2010a).…”

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confidence: 99%

Comparison of acquisition protocols for ventilation/perfusion SPECT—a Monte Carlo study

et al. 2019

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Pulmonary embolism (PE) most commonly consists of blood clots transported in the blood stream to the heart and further to the lungs where they get trapped in different levels of the lung arteries. This often causes wedgeshaped perfusion defects (PD) with the base against a peripheral pleural surface (Sinner 1978, Bajc et al 2009. If left untreated, PE can be fatal or lead to chronic thromboembolic pulmonary hypertension (Bajc et al 2009, Le Roux et al 2018a. Anticoagulation therapy used in the treatment of PE, on the other hand, exposes patients to a significant risk of bleeding-related side effects (Carrier et al 2010b). In the diagnosis of PE, it is therefore of utmost importance to make an accurate diagnosis.The most commonly used imaging techniques for diagnosing PE are multidetector computed tomography (MDCT) and ventilation/perfusion (V/P) scintigraphy (Bajc et al 2009, Parekh et al 2017, Le Roux et al 2018b. Recent technical improvements in Magnetic resonance imaging (MRI) have also opened possibilities for the technique to be used for detection of PE (Pasin et al 2017, Nyren et al 2017. In the case of scintigraphy, V/P single photon emission computed tomography (V/P SPECT) has the advantage over planar imaging of enabling cross sectional images of the activity distribution facilitating anatomical localization. This also overcomes problems with overlaying anatomy

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Ventilation/Perfusion SPECT Imaging Diagnosing PE and Other Cardiopulmonary Diseases

Bajc

Lindqvist

2020

Clinical Nuclear Medicine

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Good clinical practice in pulmonary embolism diagnosis: where do we stand today?

Cited by 8 publications

References 16 publications

Ventilation-perfusion (V/Q) lung scintigraphy: a long journey to a renewed position of prominence in diagnosing pulmonary embolism

Ventilation-perfusion (V/Q) lung scintigraphy: a long journey to a renewed position of prominence in diagnosing pulmonary embolism

Comparison of acquisition protocols for ventilation/perfusion SPECT—a Monte Carlo study

Ventilation/Perfusion SPECT Imaging Diagnosing PE and Other Cardiopulmonary Diseases

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