Three-year clinical experience with VQ SPECT for diagnosing pulmonary embolism: diagnostic performance

Grüning, Thomas; Drake, Brent; Farrell, Sally L.; Nokes, Timothy J.

doi:10.1016/j.clinimag.2014.04.003

Cited by 39 publications

(50 citation statements)

References 12 publications

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“…Compared with traditional planar V/Q imaging, V/Q SPECT offers a better spatial resolution and a limitation of the overlapping of perfusion defects by other structures [8][9][10]. The diagnostic performance of V/Q SPECT has been reported in several accuracy and cohort studies [11][12][13][14][15], and interpretation criteria dedicated to V/Q SPECT have been validated [16][17][18]. Improved performance of V/Q SPECT could allow safe and simplified algorithm strategies while maintaining the advantages of V/Q scintigraphy (i.e.…”

Section: Introductionmentioning

confidence: 97%

Additional value of combining low-dose computed tomography to V/Q SPECT on a hybrid SPECT-CT camera for pulmonary embolism diagnosis

Roux

Robin

Delluc

et al. 2015

Nuclear Medicine Communications

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Section: Introductionmentioning

confidence: 97%

Additional value of combining low-dose computed tomography to V/Q SPECT on a hybrid SPECT-CT camera for pulmonary embolism diagnosis

Roux

Robin

Delluc

et al. 2015

Nuclear Medicine Communications

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“…5 PE may be identified or excluded by several diagnostic and clinical tests. These include clinical scores (modified Wells' score 6 ), plasma D-dimer measurement, CT pulmonary angiography (CTPA) and ventilation/perfusion (VQ) scanning, [7][8][9] although the diagnostic performance of some of these, e.g. plasma Ddimer 10 and CTPA, [11][12][13][14][15] is impaired during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Diagnosing venous thromboembolism in pregnancy

Grüning

Mingo

Gosling

et al. 2016

BJR

Self Cite

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Objective: We report the imaging outcomes of all pregnant patients referred for suspected thromboembolism over a 43-month period. Methods: We identified 168 patients who underwent ventilation/perfusion (VQ) single-photon emission CT (SPECT), CT pulmonary angiography (CTPA) or a Doppler ultrasound scan of the lower legs, as well as a control group of 89 non-pregnant age-and sex-matched patients who underwent VQ SPECT during the same period. Imaging outcomes were recorded, and radiation doses were calculated for individual patients. Results: VQ SPECT and CTPA were equally likely to diagnose pulmonary embolism (PE) in about one patient out of every seven patients investigated. One in three CTPA scans was of suboptimal quality. A Doppler ultrasound examination of the legs will find deep venous thrombosis much less often, in about 1 patient out of every 15 patients investigated. The prevalence of PE in pregnant patients (as diagnosed by VQ SPECT) was similar to that in the non-pregnant, age-and sex-matched control group. The effective dose and the absorbed radiation dose to the maternal breast were lower with VQ SPECT. The foetal dose is comparable for both VQ SPECT and CTPA. Conclusion: VQ SPECT and CTPA provide a similar diagnostic yield for diagnosing PE during pregnancy, but VQ SPECT does so with a lower radiation dose to the mother (effective dose and breast dose). Advances in knowledge: Ours is the first report of the diagnostic performance of VQ SPECT, rather than planar VQ scans, in pregnancy in a routine clinical setting.

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“…The rate of inconclusive V/Q SPECT reports in our institution is in line with other institutions which use a similar technique (Technegas and MAA‐based V/Q SPECT imaging). Recent UK research (including 3 years of V/Q SPECT studies) revealed a non‐diagnostic rate of 1% ( N = 21/1950 studies) . A large Swedish study (2328 patients, 2008) indicated rates of equivocal findings in approximately 1% of studies performed .…”

Section: Discussionmentioning

confidence: 99%

“…Recent UK research (including 3 years of V/Q SPECT studies) revealed a non-diagnostic rate of 1% (N = 21/1950 studies). 12 A large Swedish study (2328 patients, 2008) indicated rates of equivocal findings in approximately 1% of studies performed. 3 A French study (584 patients, 2005) stated inconclusive findings in 3% of V/Q SPECT reports.…”

Section: Discussionmentioning

confidence: 99%

Ventilation perfusion single photon emission computed tomography: Referral practices and diagnosis of acute pulmonary embolism in the quaternary clinical setting

Lawrence

Kyle

2018

J Med Imag Rad Onc

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Introduction Ventilation perfusion single photon emission computed tomography (V/Q SPECT) and CTPA are the two leading imaging studies used to investigate acute pulmonary embolism. V/Q SPECT is often the first line investigation for pregnant patients and young females. Historically, V/Q Planar studies have high rates of indeterminate findings resulting in a preference for CTPA studies. The purpose of this research is to examine current V/Q SPECT referral practices in the quaternary clinical setting and to confirm V/Q SPECT studies have low rates of equivocal findings. Methods Retrospective study of a 6‐month period of all completed V/Q SPECT studies (± LDCT) indicated for investigation of acute PE. V/Q SPECT studies were reported using the European Association of Nuclear Medicine guidelines. Patient demographic data and V/Q SPECT findings were recorded. CTPA and Doppler Ultrasound report findings were included if performed 48 hours prior to, or following V/Q SPECT study. Standard descriptive statistical analysis was undertaken. Results Ninety‐nine percent of V/Q SPECT studies had reports positive or negative for acute PE, with 1% inconclusive. Twenty‐two percent of patients had either CTPA or Doppler Ultrasound studies within a 48‐ hour period prior to, or following V/Q SPECT, with the majority having a negative Doppler ultrasound prior to negative V/Q SPECT. Sixty‐eight percent of patients referred for V/Q SPECT were females under the age of 55, 40% of whom were pregnant. Conclusions Ventilation perfusion single photon emission computed tomography has low rates of equivocal findings with referral practices indicating pregnant patients and young women are considered to most benefit from V/Q SPECT as a first line investigation for acute PE.

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Three-year clinical experience with VQ SPECT for diagnosing pulmonary embolism: diagnostic performance

Cited by 39 publications

References 12 publications

Additional value of combining low-dose computed tomography to V/Q SPECT on a hybrid SPECT-CT camera for pulmonary embolism diagnosis

Additional value of combining low-dose computed tomography to V/Q SPECT on a hybrid SPECT-CT camera for pulmonary embolism diagnosis

Diagnosing venous thromboembolism in pregnancy

Ventilation perfusion single photon emission computed tomography: Referral practices and diagnosis of acute pulmonary embolism in the quaternary clinical setting

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