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A comparison of single-photon emission CT lung scintigraphy and CT pulmonary angiography for the diagnosis of pulmonary embolism.
Chest 2009; 136(6):1546-1553Chest

Abstract

BACKGROUND

This study compared single-photon emission CT (SPECT) ventilation/perfusion (V/Q) scintigraphy with multislice CT pulmonary angiography (CTPA).

METHODS

In a prospective, observational study, 100 patients who were >or= 50 years of age were recruited. Seventy-nine patients underwent both diagnostic 16-detector CTPA, and planar and SPECT V/Q scintigraphy. The agreement between the CTPA and the SPECT V/Q scintigraphy for the diagnosis of pulmonary embolism (PE) was calculated. The sensitivity and specificity of blinded SPECT scintigraphy reporting was calculated against a reference diagnosis made by a panel of respiratory physicians that was provided with CTPA and planar V/Q scintigraphy reports, clinical information, and 3-month follow-up data.

RESULTS

The observed percentage of agreement between SPECT V/Q scintigraphy and CTPA data for the diagnosis of PE was 95%. When calculated against the respiratory physicians' reference diagnosis, SPECT V/Q scintigraphy had a sensitivity of 83% and a specificity of 98%.

CONCLUSIONS

This study indicates that SPECT V/Q scintigraphy is a viable alternative to CTPA for the diagnosis of PE and has potential advantages in that it was feasible in more patients and had fewer contraindications; lower radiation dose; and, arguably, fewer nondiagnostic findings than CTPA.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry Registration Number: ACTRN12609000089235.

Authors+Show Affiliations

Department of General Medicine, Calvary Mater Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia. Electronic address: susan.miles@mater.health.nsw.gov.au.Department of Nuclear Medicine, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.Department of Nuclear Medicine, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia; Department of Queensland PET Service, Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.Department of Radiology, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.Department of Hunter Medical Research Institute, Department of Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Department of Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia.Department of Radiology, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.Department of Radiology, Hunter New England Imaging, John Hunter Hospital, Newcastle, NSW, Australia.Department of Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia.Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Department of School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19525358

Citation

Miles, Susan, et al. "A Comparison of Single-photon Emission CT Lung Scintigraphy and CT Pulmonary Angiography for the Diagnosis of Pulmonary Embolism." Chest, vol. 136, no. 6, 2009, pp. 1546-1553.
Miles S, Rogers KM, Thomas P, et al. A comparison of single-photon emission CT lung scintigraphy and CT pulmonary angiography for the diagnosis of pulmonary embolism. Chest. 2009;136(6):1546-1553.
Miles, S., Rogers, K. M., Thomas, P., Soans, B., Attia, J., Abel, C., ... Hensley, M. J. (2009). A comparison of single-photon emission CT lung scintigraphy and CT pulmonary angiography for the diagnosis of pulmonary embolism. Chest, 136(6), pp. 1546-1553. doi:10.1378/chest.09-0361.
Miles S, et al. A Comparison of Single-photon Emission CT Lung Scintigraphy and CT Pulmonary Angiography for the Diagnosis of Pulmonary Embolism. Chest. 2009;136(6):1546-1553. PubMed PMID: 19525358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of single-photon emission CT lung scintigraphy and CT pulmonary angiography for the diagnosis of pulmonary embolism. AU - Miles,Susan, AU - Rogers,Kerry M, AU - Thomas,Paul, AU - Soans,Barry, AU - Attia,John, AU - Abel,Christian, AU - Holt,Elizabeth, AU - D'Este,Catherine A, AU - Hensley,Michael J, Y1 - 2009/06/12/ PY - 2009/6/16/entrez PY - 2009/6/16/pubmed PY - 2010/1/1/medline SP - 1546 EP - 1553 JF - Chest JO - Chest VL - 136 IS - 6 N2 - BACKGROUND: This study compared single-photon emission CT (SPECT) ventilation/perfusion (V/Q) scintigraphy with multislice CT pulmonary angiography (CTPA). METHODS: In a prospective, observational study, 100 patients who were >or= 50 years of age were recruited. Seventy-nine patients underwent both diagnostic 16-detector CTPA, and planar and SPECT V/Q scintigraphy. The agreement between the CTPA and the SPECT V/Q scintigraphy for the diagnosis of pulmonary embolism (PE) was calculated. The sensitivity and specificity of blinded SPECT scintigraphy reporting was calculated against a reference diagnosis made by a panel of respiratory physicians that was provided with CTPA and planar V/Q scintigraphy reports, clinical information, and 3-month follow-up data. RESULTS: The observed percentage of agreement between SPECT V/Q scintigraphy and CTPA data for the diagnosis of PE was 95%. When calculated against the respiratory physicians' reference diagnosis, SPECT V/Q scintigraphy had a sensitivity of 83% and a specificity of 98%. CONCLUSIONS: This study indicates that SPECT V/Q scintigraphy is a viable alternative to CTPA for the diagnosis of PE and has potential advantages in that it was feasible in more patients and had fewer contraindications; lower radiation dose; and, arguably, fewer nondiagnostic findings than CTPA. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry Registration Number: ACTRN12609000089235. SN - 1931-3543 UR - https://www.unboundmedicine.com/medline/citation/19525358/A_comparison_of_single_photon_emission_CT_lung_scintigraphy_and_CT_pulmonary_angiography_for_the_diagnosis_of_pulmonary_embolism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(09)60735-2 DB - PRIME DP - Unbound Medicine ER -