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Safety of ventilation/perfusion single photon emission computed tomography for pulmonary embolism diagnosis.
Eur J Nucl Med Mol Imaging 2014; 41(10):1957-64EJ

Abstract

PURPOSE

The aim of this management outcome study was to assess the safety of ventilation/perfusion single photon emission computed tomography (V/Q SPECT) for the diagnosis of pulmonary embolism (PE) using for interpretation the criteria proposed in the European Association of Nuclear Medicine (EANM) guidelines for V/Q scintigraphy.

METHODS

A total of 393 patients with clinically suspected PE referred to the Nuclear Medicine Department of Brest University Hospital from April 2011 to March 2013, with either a high clinical probability or a low or intermediate clinical probability but positive D-dimer, were retrospectively analysed. V/Q SPECT were interpreted by the attending nuclear medicine physician using a diagnostic cut-off of one segmental or two subsegmental mismatches. The final diagnostic conclusion was established by the physician responsible for patient care, based on clinical symptoms, laboratory test, V/Q SPECT and other imaging procedures performed. Patients in whom PE was deemed absent were not treated with anticoagulants and were followed up for 3 months.

RESULTS

Of the 393 patients, the prevalence of PE was 28 %. V/Q SPECT was positive for PE in 110 patients (28 %) and negative in 283 patients (72 %). Of the 110 patients with a positive V/Q SPECT, 78 (71 %) had at least one additional imaging test (computed tomography pulmonary angiography or ultrasound) and the diagnosis of PE was eventually excluded in one patient. Of the 283 patients with a negative V/Q SPECT, 74 (26 %) patients had another test. The diagnosis of PE was finally retained in one patient and excluded in 282 patients. The 3-month thromboembolic risk in the patients not treated with anticoagulants was 1/262: 0.38 % (95 % confidence interval 0.07-2.13).

CONCLUSION

A diagnostic management including V/Q SPECT interpreted with a diagnostic cut-off of "one segmental or two subsegmental mismatches" appears safe to exclude PE.

Authors+Show Affiliations

Université Européenne de Bretagne, Brest, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

24719158

Citation

Le Roux, Pierre-Yves, et al. "Safety of Ventilation/perfusion Single Photon Emission Computed Tomography for Pulmonary Embolism Diagnosis." European Journal of Nuclear Medicine and Molecular Imaging, vol. 41, no. 10, 2014, pp. 1957-64.
Le Roux PY, Palard X, Robin P, et al. Safety of ventilation/perfusion single photon emission computed tomography for pulmonary embolism diagnosis. Eur J Nucl Med Mol Imaging. 2014;41(10):1957-64.
Le Roux, P. Y., Palard, X., Robin, P., Delluc, A., Abgral, R., Querellou, S., ... Salaun, P. Y. (2014). Safety of ventilation/perfusion single photon emission computed tomography for pulmonary embolism diagnosis. European Journal of Nuclear Medicine and Molecular Imaging, 41(10), pp. 1957-64. doi:10.1007/s00259-014-2763-1.
Le Roux PY, et al. Safety of Ventilation/perfusion Single Photon Emission Computed Tomography for Pulmonary Embolism Diagnosis. Eur J Nucl Med Mol Imaging. 2014;41(10):1957-64. PubMed PMID: 24719158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety of ventilation/perfusion single photon emission computed tomography for pulmonary embolism diagnosis. AU - Le Roux,Pierre-Yves, AU - Palard,Xavier, AU - Robin,Philippe, AU - Delluc,Aurélien, AU - Abgral,Ronan, AU - Querellou,Solène, AU - Couturaud,Francis, AU - Le Gal,Grégoire, AU - Salaun,Pierre-Yves, Y1 - 2014/04/10/ PY - 2014/01/08/received PY - 2014/03/17/accepted PY - 2014/4/11/entrez PY - 2014/4/11/pubmed PY - 2015/6/6/medline SP - 1957 EP - 64 JF - European journal of nuclear medicine and molecular imaging JO - Eur. J. Nucl. Med. Mol. Imaging VL - 41 IS - 10 N2 - PURPOSE: The aim of this management outcome study was to assess the safety of ventilation/perfusion single photon emission computed tomography (V/Q SPECT) for the diagnosis of pulmonary embolism (PE) using for interpretation the criteria proposed in the European Association of Nuclear Medicine (EANM) guidelines for V/Q scintigraphy. METHODS: A total of 393 patients with clinically suspected PE referred to the Nuclear Medicine Department of Brest University Hospital from April 2011 to March 2013, with either a high clinical probability or a low or intermediate clinical probability but positive D-dimer, were retrospectively analysed. V/Q SPECT were interpreted by the attending nuclear medicine physician using a diagnostic cut-off of one segmental or two subsegmental mismatches. The final diagnostic conclusion was established by the physician responsible for patient care, based on clinical symptoms, laboratory test, V/Q SPECT and other imaging procedures performed. Patients in whom PE was deemed absent were not treated with anticoagulants and were followed up for 3 months. RESULTS: Of the 393 patients, the prevalence of PE was 28 %. V/Q SPECT was positive for PE in 110 patients (28 %) and negative in 283 patients (72 %). Of the 110 patients with a positive V/Q SPECT, 78 (71 %) had at least one additional imaging test (computed tomography pulmonary angiography or ultrasound) and the diagnosis of PE was eventually excluded in one patient. Of the 283 patients with a negative V/Q SPECT, 74 (26 %) patients had another test. The diagnosis of PE was finally retained in one patient and excluded in 282 patients. The 3-month thromboembolic risk in the patients not treated with anticoagulants was 1/262: 0.38 % (95 % confidence interval 0.07-2.13). CONCLUSION: A diagnostic management including V/Q SPECT interpreted with a diagnostic cut-off of "one segmental or two subsegmental mismatches" appears safe to exclude PE. SN - 1619-7089 UR - https://www.unboundmedicine.com/medline/citation/24719158/Safety_of_ventilation/perfusion_single_photon_emission_computed_tomography_for_pulmonary_embolism_diagnosis_ L2 - https://dx.doi.org/10.1007/s00259-014-2763-1 DB - PRIME DP - Unbound Medicine ER -