Tags

Type your tag names separated by a space and hit enter

Contribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolism.
Rev Esp Med Nucl Imagen Mol 2014 May-Jun; 33(3):153-8RE

Abstract

AIM

To evaluate the feasibility of V/Q SPECT and analyze its contribution to planar V/Q lung scintigraphy in the diagnosis of pulmonary embolism (PE).

MATERIAL AND METHODS

A total of 109 patients with suspected PE showing Wells score>2 and elevated D-dimer were studied. The V/Q could not be completed in 7 patients, so they were excluded. Ventilation and perfusion scans were done using Technegas and (99m)Tc-MAA. Planar study included 8 projections on a 256×256 matrix and 128 projections on a 128×128 matrix were acquired for the SPECT study, applying an iterative method. Planar images were interpreted according to modified PIOPED criteria, and SPECT by the guidelines of the EANMMI. The results with both techniques were compared.

RESULTS

V/Q planar scintigraphy and SPECT could be performed in 102 patients. V/Q planar scintigraphy was considered "diagnostic" in 39 of the 102 patients, and "non-diagnostic" in 63. Of the 39 "diagnostic" studies, 31 were reported as high probability of PE and 8 as normal. Of the 63 "non-diagnostic", 26 corresponded to intermediate, 29 to low, and 8 to very low probability. The SPECT study was "diagnostic" in 97 and indeterminate in only 5. All patients with a high probability planar scintigraphy had a positive SPECT. In the 8 patients with a normal planar scintigraphy SPECT was negative in 5 and positive in 3. In the 63 patients with a "non-diagnostic" planar scintigraphy SPECT was "diagnostic" in 58 of them, positive in 17 and negative in 41.

CONCLUSION

V/Q SPECT is a feasible technique as it was performed in 102 of the 109 patients who were enrolled in the study (94%). The addition of V/Q SPECT to planar V/Q decreases the number of "non-diagnostic" reports from 62% in planar scintigraphy to 4.9% in SPECT. Therefore, V/Q SPECT should be included in the diagnosis approach of PE due to its high diagnostic yield.

Authors+Show Affiliations

Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain. Electronic address: mnuqpm@humv.es.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

24485808

Citation

Quirce, R, et al. "Contribution of V/Q SPECT to Planar Scintigraphy in the Diagnosis of Pulmonary Embolism." Revista Espanola De Medicina Nuclear E Imagen Molecular, vol. 33, no. 3, 2014, pp. 153-8.
Quirce R, Ibáñez-Bravo S, Jiménez-Bonilla J, et al. Contribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolism. Rev Esp Med Nucl Imagen Mol. 2014;33(3):153-8.
Quirce, R., Ibáñez-Bravo, S., Jiménez-Bonilla, J., Martínez-Rodríguez, I., Martínez-Amador, N., Ortega-Nava, F., ... Carril, J. M. (2014). Contribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolism. Revista Espanola De Medicina Nuclear E Imagen Molecular, 33(3), pp. 153-8. doi:10.1016/j.remn.2013.12.001.
Quirce R, et al. Contribution of V/Q SPECT to Planar Scintigraphy in the Diagnosis of Pulmonary Embolism. Rev Esp Med Nucl Imagen Mol. 2014;33(3):153-8. PubMed PMID: 24485808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolism. AU - Quirce,R, AU - Ibáñez-Bravo,S, AU - Jiménez-Bonilla,J, AU - Martínez-Rodríguez,I, AU - Martínez-Amador,N, AU - Ortega-Nava,F, AU - Lavado-Pérez,C, AU - Bravo-Ferrer,Z, AU - Carril,J M, Y1 - 2014/01/31/ PY - 2013/10/22/received PY - 2013/12/20/revised PY - 2013/12/21/accepted PY - 2014/2/4/entrez PY - 2014/2/4/pubmed PY - 2015/7/29/medline KW - Enfermedad venosa tromboembólica KW - Gammagrafía V/Q KW - Gammagrafía pulmonar de ventilación-perfusión KW - Pulmonary embolism KW - SPECT V/Q KW - Technegas KW - Tromboembolismo pulmonar KW - V/Q SPECT KW - V/Q scintigraphy KW - Venous thromboembolic disease KW - Ventilation–perfusion lung scan SP - 153 EP - 8 JF - Revista espanola de medicina nuclear e imagen molecular JO - Rev Esp Med Nucl Imagen Mol VL - 33 IS - 3 N2 - AIM: To evaluate the feasibility of V/Q SPECT and analyze its contribution to planar V/Q lung scintigraphy in the diagnosis of pulmonary embolism (PE). MATERIAL AND METHODS: A total of 109 patients with suspected PE showing Wells score>2 and elevated D-dimer were studied. The V/Q could not be completed in 7 patients, so they were excluded. Ventilation and perfusion scans were done using Technegas and (99m)Tc-MAA. Planar study included 8 projections on a 256×256 matrix and 128 projections on a 128×128 matrix were acquired for the SPECT study, applying an iterative method. Planar images were interpreted according to modified PIOPED criteria, and SPECT by the guidelines of the EANMMI. The results with both techniques were compared. RESULTS: V/Q planar scintigraphy and SPECT could be performed in 102 patients. V/Q planar scintigraphy was considered "diagnostic" in 39 of the 102 patients, and "non-diagnostic" in 63. Of the 39 "diagnostic" studies, 31 were reported as high probability of PE and 8 as normal. Of the 63 "non-diagnostic", 26 corresponded to intermediate, 29 to low, and 8 to very low probability. The SPECT study was "diagnostic" in 97 and indeterminate in only 5. All patients with a high probability planar scintigraphy had a positive SPECT. In the 8 patients with a normal planar scintigraphy SPECT was negative in 5 and positive in 3. In the 63 patients with a "non-diagnostic" planar scintigraphy SPECT was "diagnostic" in 58 of them, positive in 17 and negative in 41. CONCLUSION: V/Q SPECT is a feasible technique as it was performed in 102 of the 109 patients who were enrolled in the study (94%). The addition of V/Q SPECT to planar V/Q decreases the number of "non-diagnostic" reports from 62% in planar scintigraphy to 4.9% in SPECT. Therefore, V/Q SPECT should be included in the diagnosis approach of PE due to its high diagnostic yield. SN - 2253-8070 UR - https://www.unboundmedicine.com/medline/citation/24485808/Contribution_of_V/Q_SPECT_to_planar_scintigraphy_in_the_diagnosis_of_pulmonary_embolism_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S2253-654X(14)00006-7 DB - PRIME DP - Unbound Medicine ER -