Diagnostic accuracy of single photo emission tomography ventilation perfusion (SPECT V/Q) lung scan in the diagnosis of pulmonary embolism.
Chest. 2011 Aug 18;
Authors: LE Duc-Pennec A, LE Roux PY, Cornily JC, Jaffrelot M, Delluc A, de Saint-Martin L, Guillo P, LE Gal G, Salaun PY, Leroyer C
ABSTRACT BACKGROUND: Planar ventilation/perfusion (V/Q) lung scintigraphy is a validated tool for the diagnosis of pulmonary embolism (PE). Nevertheless, further investigation is often necessary given the high rate of non conclusive V/Q. V/Q SPECT could improve V/Q performances, but sparse data are available on its accuracy. OBJECTIVES: This study assesses the diagnostic performance of V/Q SPECT in a cohort of consecutive patients with suspected PE. Patients/ METHODS: 321 consecutive patients with a clinical suspicion of PE were prospectively included. Patients suspected of having PE were managed according to a reference diagnostic strategy validated by a 3-month follow-up. In addition to the reference strategy, patients had a V/Q SPECT, the results of which were compared to the initial work up results. RESULTS: Prevalence of PE was 0/41 (0%, 95% CI: 0 to 9), 6/134 (4%, 95% CI: 2 to 9), 15/36 (42%, 95% CI: 27 to 58), and 28/32 (88%, 95% CI: 72 to 95) in the normal, low, intermediate and high V/Q SPECT probability groups, respectively. The combination of V/Q SPECT with clinical probability was diagnostic in 88% of patients. CONCLUSIONS: V/Q SPECT results show satisfactory accuracy for PE diagnosis. Validation of dedicated interpretation criteria is required, followed by outcome studies that use VQ SPECT as part of a diagnostic strategy to rule out PE.
PMID: 21852295 [PubMed - as supplied by publisher]