Ventilation/Perfusion SPECT for Diagnosis of Pulmonary Embolism and Other Diseases

Abstract

V/PSPECT has the potential to become a first hand tool for diagnosis of pulmonary embolism based on standardized technology and new holistic interpretation criteria. Pretest probability helps clinicians choose the most appropriate objective test for diagnosis or exclusion of PE. Interpretation should also take into account all ventilation and perfusion patterns allowing diagnosis of other cardiopulmonary diseases than PE. In such contexts, V/PSPECT has excellent sensitivity and specificity. Nondiagnostic reports are ≤3%. V/PSPECT has no contraindication; it is noninvasive and has very low radiation exposure. Moreover, acquisition time for V/PSPECT is only 20 minutes. It allows quantification of PE extension which has an impact on individual treatment. It is uniquely useful for followup and research.

A hybrid multibreath wash-in wash-out lung function quantification scheme in human subjects using hyperpolarized3He MRI for simultaneous assessment of specific ventilation, alveolar oxygen tension, oxygen uptake, and air trapping

“…Although alternative methods to map both ventilation and oxygen tension exist , as well as the aforementioned DL CO as an analog of oxygen uptake, direct comparisons are difficult because the methods are either qualitative (“weighting”) techniques, quantitative but sensitive to slightly different aspects of the lung, or susceptible to known but different sources of error than these HP methods. Notably, all methods for measuring ventilation regionally suffer from a definitional ambiguity with respect to the source of the gas arriving at the region after inhalation.…”

Competitive assessments of pulmonary embolism: Noninvasiveness versus the golden standard

“…It has excellent sensitivity and specificity, fast procedure, few complications and contradictions, noninvasive and very low radiation exposure. [61][62][63][64][65][66] Since 1980s, numerous studies have shown advantages of V/Q SPECT over alternative techniques (Table 1), which indicate that lung scintigraphy is again appreciated as a firsthand tool for diagnosis of PE. However, large-scale prospective studies are needed to validate these new approaches.…”

Pulmonary ventilation/perfusion single photon emission tomography – Initial experience of a Nuclear Medicine Department

“…14 The most recent development in V/QS was the introduction of pulmonary ventilation and perfusion tomographic imaging (V/QS-SPECT). 15,16 V/QS-SPECT has the same conceptual basis of V/QS-planar, the only difference being that in V/QS-SPECT tomographic reconstructions of pulmonary ventilation and perfusion are acquired, allowing the evaluation of axial, coronal and sagittal planes. This technique has a solid experimental support, 17 appears to have higher diagnostic sensitivity than V/QS-planar 18,19 and does not seem to imply additional resource consumption.…”