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The Utility of Hybrid SPECT/CT Lung Perfusion Scintigraphy in Pulmonary Embolism Diagnosis.
Respiration 2015; 90(5):393-401R

Abstract

BACKGROUND

Pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/Q) scintigraphy or pulmonary CT angiography. One of the imaging methods used in nuclear medicine is hybrid SPECT/CT scintigraphy.

OBJECTIVES

The aim of this study was to evaluate the utility of SPECT/CT(Q) scintigraphy in the diagnosis of PE and to compare SPECT/CT(Q) with planar(Q) and SPECT(Q) methods.

METHODS

The study group consisted of 109 consecutive patients suspected of having PE referred for performing lung scintigraphy. The inclusion criteria were: performance of perfusion planar, SPECT and SPECT/CT scans; availability of clinical data covering a 6-month follow-up period, and D-dimer level testing. The number of eligible patients was 84. PE was reported in patients with at least 1 segmental or 2 subsegmental perfusion defects without parenchymal abnormalities on CT scans. PE was excluded when there was a normal perfusion pattern or perfusion defects were caused by lung parenchymal abnormalities or were not arranged in accordance with the pulmonary vasculature.

RESULTS

Twenty-six patients (31%) had a final diagnosis of PE. The sensitivity and specificity values of each method were as follows: planar(Q) 73 and 43%, SPECT(Q) 88 and 47% and SPECT/CT(Q) 100 and 83%. SPECT/CT(Q) yielded a significantly higher diagnostic accuracy than planar(Q) (p < 0.001) and SPECT(Q) (p < 0.001) scans.

CONCLUSIONS

We conclude that hybrid SPECT/CT(Q) imaging has a high diagnostic efficacy in the diagnosis of PE. Lung perfusion scintigraphy performed with a hybrid SPECT/CT device has a significantly higher sensitivity and specificity than scanning performed with the planar or SPECT technique.

Authors+Show Affiliations

Department of Nuclear Medicine, Military Institute of Medicine, Warsaw, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26418469

Citation

Mazurek, Andrzej, et al. "The Utility of Hybrid SPECT/CT Lung Perfusion Scintigraphy in Pulmonary Embolism Diagnosis." Respiration; International Review of Thoracic Diseases, vol. 90, no. 5, 2015, pp. 393-401.
Mazurek A, Dziuk M, Witkowska-Patena E, et al. The Utility of Hybrid SPECT/CT Lung Perfusion Scintigraphy in Pulmonary Embolism Diagnosis. Respiration. 2015;90(5):393-401.
Mazurek, A., Dziuk, M., Witkowska-Patena, E., Piszczek, S., & Gizewska, A. (2015). The Utility of Hybrid SPECT/CT Lung Perfusion Scintigraphy in Pulmonary Embolism Diagnosis. Respiration; International Review of Thoracic Diseases, 90(5), pp. 393-401. doi:10.1159/000439543.
Mazurek A, et al. The Utility of Hybrid SPECT/CT Lung Perfusion Scintigraphy in Pulmonary Embolism Diagnosis. Respiration. 2015;90(5):393-401. PubMed PMID: 26418469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Utility of Hybrid SPECT/CT Lung Perfusion Scintigraphy in Pulmonary Embolism Diagnosis. AU - Mazurek,Andrzej, AU - Dziuk,Miroslaw, AU - Witkowska-Patena,Ewa, AU - Piszczek,Stanislaw, AU - Gizewska,Agnieszka, Y1 - 2015/09/30/ PY - 2015/05/11/received PY - 2015/08/14/accepted PY - 2015/9/30/entrez PY - 2015/9/30/pubmed PY - 2016/9/9/medline SP - 393 EP - 401 JF - Respiration; international review of thoracic diseases JO - Respiration VL - 90 IS - 5 N2 - BACKGROUND: Pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/Q) scintigraphy or pulmonary CT angiography. One of the imaging methods used in nuclear medicine is hybrid SPECT/CT scintigraphy. OBJECTIVES: The aim of this study was to evaluate the utility of SPECT/CT(Q) scintigraphy in the diagnosis of PE and to compare SPECT/CT(Q) with planar(Q) and SPECT(Q) methods. METHODS: The study group consisted of 109 consecutive patients suspected of having PE referred for performing lung scintigraphy. The inclusion criteria were: performance of perfusion planar, SPECT and SPECT/CT scans; availability of clinical data covering a 6-month follow-up period, and D-dimer level testing. The number of eligible patients was 84. PE was reported in patients with at least 1 segmental or 2 subsegmental perfusion defects without parenchymal abnormalities on CT scans. PE was excluded when there was a normal perfusion pattern or perfusion defects were caused by lung parenchymal abnormalities or were not arranged in accordance with the pulmonary vasculature. RESULTS: Twenty-six patients (31%) had a final diagnosis of PE. The sensitivity and specificity values of each method were as follows: planar(Q) 73 and 43%, SPECT(Q) 88 and 47% and SPECT/CT(Q) 100 and 83%. SPECT/CT(Q) yielded a significantly higher diagnostic accuracy than planar(Q) (p < 0.001) and SPECT(Q) (p < 0.001) scans. CONCLUSIONS: We conclude that hybrid SPECT/CT(Q) imaging has a high diagnostic efficacy in the diagnosis of PE. Lung perfusion scintigraphy performed with a hybrid SPECT/CT device has a significantly higher sensitivity and specificity than scanning performed with the planar or SPECT technique. SN - 1423-0356 UR - https://www.unboundmedicine.com/medline/citation/26418469/The_Utility_of_Hybrid_SPECT/CT_Lung_Perfusion_Scintigraphy_in_Pulmonary_Embolism_Diagnosis_ L2 - https://www.karger.com?DOI=10.1159/000439543 DB - PRIME DP - Unbound Medicine ER -